When billing for multiple procedures on the same day, use this step by step procedure to determine if you should bill for more than one procedure, and if so, if you should use modifier 51 or modifier 59. It is critical to have access to National Correct Coding Initiative ((NCCI) edits in your software program. […]
Surgical procedures, modifiers, and the global package
CMS and CPT both define the components of the global surgical package to include certain pre-op, intra-op, and post-op services. Learn what is included in the single payment, what may be reported separately and how to do it.
Modifier 57
Decision for Surgery. An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E/M service. The payment for major surgery includes E/M services provided on the day of and the day before a major surgical procedure, unless it […]
Modifier 24
Understanding E/M modifiers is important for both revenue and compliance. Failing to apply the correct modifier reduces revenue. Applying the wrong modifier or using it when it is not accurate is a compliance issue and puts the practice at risk for payback and disclosures. For additional information, see the article on Global Surgical Package. Modifier […]
Coding Guide – Global Surgery
This guide from CodingIntel explains surgery coding guidelines and the global period for procedures, and includes the contents of our original CPT® and HCPCS Modifier Guide.
Billing Admission and Subsequent Visits for Patient Having Surgery
What if I admit a patient and don’t take the patient immediately to surgery? Can I bill for the admission and subsequent visits if the patient goes to surgery later in the week? In this case it depends on when you admit the patient and when you decide to take the patient to surgery. A […]
Excision of Benign or Malignant Lesions
This article reviews codes and guidelines for excision of skin lesions. For more information about minor procedures, see additional resources at the bottom of this page. This article includes: CPT® codes for excision Excision of benign lesions Excision of malignant lesions Excision of soft tumors Reporting Excision of Multiple Lesions of the Same Size Coding […]
Surgical Modifiers
This article includes: Surgical modifiers with definitions Guidelines for billing multiple surgical procedures Modifiers in the post-op period Avoiding CPT® modifier mishaps Citations Members can also download the Global Surgery Coding Guide. Some of the information in this article and in the billing guide is the same. Billing for Surgical Services Before submitting a claim […]
Can I Get Paid for…an Office Visit the Same Day as a Minor Procedure
Can you bill an E/M service on the same day as a minor procedure? Sometimes yes, sometimes no. The decision to perform a minor procedure is included in the payment for the procedure, unless a significant and separate E/M is needed, performed and documented. Watch this short video to learn more.
Can I Get Paid for…Evaluation Prior to Surgery
The surgeon evaluates a patient, and determines that surgery is needed. Can the surgeon get paid for this initial service? Watch this short video about billing for evaluation prior to surgery. See also modifier 57. Back to list Relevant Search Terms: modifier 57, global surgical package, global surgery