Modifier 24 reflects the nature of the E/M. Modifier 25 has complex requirements. Using gained knowledge and the CPT manual, compare and contrast these two modifiers
What will be an ideal response?
Answers should include (but may not be limited to) the following:
Modifier 24 documents an E/M visit performed during postoperative period for a presenting problem that is unrelated to the reason for the surgery.
Modifier 25 has four specific criteria: Content of service must be documented for the E/M service and must support at least a problem-focused (or level 1) service; the E/M service must be performed for an identifiably different reason from that of the other service or procedure; the same physician must perform both services; the services must occur on the same day.
Compare the differences between these two modifiers in the performance of an E/M service.
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concerned about based on the history and assessment findings? a. A subdural hematoma b. A scalp laceration c. A concussion d. A cerebral contusion
Describe the following activities that are completed through utilization management: preadmission certification, preauthorization, concurrent review and discharge planning