Medical Auditing Practice Exam

Which situation would illustrate an appropriate use of modifier 24?

1. A patient has a follow-up visit for a surgical complication

2. A physician admits a patient during a global period for unrelated services

3. A physician re-evaluates a condition within the global period

4. A patient requires additional tests related to ongoing treatment

The correct answer is: A physician admits a patient during a global period for unrelated services

Using modifier 24 is appropriate in the context of a physician providing unrelated evaluation and management services during a global period following surgery. Modifier 24 indicates that the service is unrelated to the prior surgery and is necessary for the evaluation and management of a new condition or problem that arises independently. In the situation involving the physician admitting a patient for unrelated services during the global period, it reflects the correct application of modifier 24. This means that while the patient is still in the global period associated with a previous surgical procedure, the services rendered are distinct and not part of the postoperative care. This distinction is crucial for proper coding and billing, ensuring that the physician can be reimbursed for services rendered, while still acknowledging the continuity of care associated with the initial surgery. The other options provided relate to services that are typically considered part of the global surgical package, which would not warrant the use of modifier 24. For instance, follow-up visits for surgical complications or re-evaluations of a condition directly related to the surgery would be included in the global period and thus not require modifier 24. Similarly, additional tests related to ongoing treatment typically fall within the scope of the original surgery's global care, making modifier 24 inappropriate in those situations.