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Click here for more sample CPC practice exam questions and answers with full rationale

Help with Claim

Can I get some input as to whether or not this qualifies as a reason for 24 modifier. Patient was seen on 6/28 for Endoscopic Plantar Fasciotomy Right foot.

On 8/3 the patient came back to the office with a chief complaint of right ankle pain due to the fact that she over did it walking at the beach. Patient was only 35 days post op at the 1st visit. Patient came in 4 times for this same problem. Blue Cross denied it, including on appeal. It is a different issue at hand but is the 24 modifier applicable in this case?

Also, on the appeal, we requested in bold letters that a “Board Certified Podiatrist” review the case. Blue Shield had a Gastroenterologist/Internal Medicine specialist do the review! Any thoughts on how to handle this. In case it is helpful, the Podiatrist is in NJ.

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