When to Use CPT 99024

CPT 99024 plays a crucial role in documenting postoperative care; however, it remains underutilized in many practices. This underutilization can send the wrong signal to some players, suggesting that the expected or allowable follow-up care after a surgical procedure is not provided. Recognizing when and how to report CPT 99024 is essential for compliance and accurate reimbursement tracking.

According to its official definition, CPT 99024 is used for a postoperative follow-up visit, usually included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure.

Understanding the appropriate scenarios for using this code helps ensure that your practice reflects the true scope of patient care delivered.

CMS Requirement for CPT 99024 Reporting in Select States

To assess the accuracy of surgical code valuations, the Centers for Medicare & Medicaid Services (CMS) required providers in certain states to report CPT 99024 for postoperative visits. This requirement applies to practitioners working in groups of 10 or more, including both physicians and non-physician practitioners, as well as those practicing under the supervision of a physician.

The mandated reporting was implemented in Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island. The purpose was to collect data that would help CMS better evaluate the frequency and nature of postoperative care, ensuring that global surgical packages reflect the actual services being delivered during the global period.

Rationale Behind State Selection and Implications of Underreporting

The states selected for mandatory CPT 99024 reporting were chosen to represent a diverse cross-section of practice environments. These selections reflected a range of sizes, measured by the number of Medicare beneficiaries, and ensured representation from all nine U.S. Census Bureau regions. While only larger practices in these states were required to report, practitioners in smaller practices or other geographic areas were encouraged, if feasible, to participate and contribute to a more comprehensive data set.

CMS has made this data publicly available through its Global Surgery Data Collection site. Independent analysis, including ongoing reports by the RAND Corporation, has revealed a trend: postoperative visits are occurring less frequently or may be underreported.

This underreporting is often attributed to evaluation and management (E/M) services being billed for unrelated diagnoses using modifier 24. Although no formal policy changes have been implemented yet, there is speculation that global periods for some surgeries could be reduced to zero days.

Such a shift may result in up to a 20% reduction in reimbursement, highlighting the importance of accurate and complete reporting. Practices should remain attentive to developments in this evolving area.

Why Practices Trust BillingFreedom for CPT 99024 and Postoperative Reporting?

Accurate and compliant reporting of postoperative services, such as CPT 99024, is more than just best practice. It can directly impact reimbursement, audit risk, and the long-term viability of your surgical billing strategy. 

At BillingFreedom, we understand the nuances involved in surgical global packages, E/M coding, and CMS reporting requirements.

Whether you're an extensive group practice in a mandated state or a smaller clinic aiming to stay proactive, our team ensures CPT 99024 is correctly captured and reported. We stay current with CMS updates, RAND findings, and policy developments to help providers avoid underreporting that could trigger payment reductions or compliance issues.

With a proven track record in surgical and specialty billing, BillingFreedom supports accurate modifier usage (like Modifier 24), proper documentation, and strategic reporting. Our system is built to safeguard your revenue while maintaining complete transparency with payers.

Let BillingFreedom help you stay ahead, ensuring every postoperative encounter is accounted for, every dollar is preserved, and every compliance box is checked.

For more details about our exceptional ob/gyn billing services, please don't hesitate to email us at info@billingfreedom.com or call us at +1 (855) 415-3472. 

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