If a patient is seen for a post operative visit (90 day global period) and the gynecology oncologist performs a simple cystometrogram after removing the foley catheter and instills 150cc for voiding study, is this separately billable or bundled with post op code?
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Tag Archives: Package
Your Quick Guide to the Global Surgical Package
Make quick and easy work of determining which procedures and services are bundled and when. Most coders, billers, and clinicians are familiar with the concept of the surgical package or global period; but they may be unclear about when the global period begins and ends, and which procedures and services may be reported (and paid […]
The post Your Quick Guide to the Global Surgical Package appeared first on AAPC Knowledge Center.
Diabetic counseling for OBs – payment outside the global package?
I’ve researched this quite a bit on the internet and AAPC forum. I’m hoping to find out if there is an OBGYN clinic who has been successful at receiving additional reimbursement for Diabetic counseling to an OB patient. Our OBGYN clinic would like to institute diabetic counseling to diabetic patients with the NP who is part of the OBGYN clinic. This would not be a service as part of their routine OB care, and would be scheduled specifically for counseling. I’ve seen options of waiting until the patient delivers and then billing an E&M if they exceed the routine 13 visits. I’ve also seen options for billing G0108 if 30 minutes of counseling is provided and billing that at the time of service. Another suggestion was bill and E&M with a -25 at the time of service. Anyone have success in billing one of these methods out of the OBGYN clinic?
Thank you
April Rader, CPC
Repeat Procedure within Global Package
A patient came in to get lesions removed using cryosurgery. 8 days later the patient comes back for a repeat procedure on the same lesions. What modifier would be appropriate to use on the CPT code 17000?
Or would this be still part of the global package and not billed?
Or would this be still part of the global package and not billed?
thank you,
Kellie
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Hosp visits with modifier 24 or part of global package? Related vs. unrelated….
The more I think about this, the more I confuse myself…..
4 m/o patient with dx of Hirschprungs disease (Q43.1) s/p surgery on 10/9/17 for complete proctectomy w/ pull through and anastomosis (45120), returned to hospital on 10/26/17 with dx of enterocolitis (K52.9). The patient is still in 30 day Medicaid global at this time. Would the hospital visits related to the 10/26/17 admission be considered related to the surgery performed on 10/9 or unrelated? The enterocolitis is certainly a complication related to the initial diagnosis as pts with Hirschprungs disease frequently do have enterocolitis but nothing in the notes indicate that the enterocolitis is a complication of the procedure itself. I am torn between making the visits post-op visits and no charge vs. whether it would be appropriate to bill these hospital visits with a 24 modifier as unrelated to the original procedure. According to SC Medicaid manual, Complications or services rendered for a diagnostic reason unrelated to the surgery may be billed with a separate examination code if the primary diagnosis reflects a different reason for the service. To report postoperative visits unrelated to surgery, submit the visit code(s) with modifier 24 or 25. The medical record must substantiate that a visit(s) was justified outside of the surgical package limitation.
Any insight would be appreciated!
Samantha
Cpt 96372 denial as anesthesia package
Howdy. Got a problem.
I work for a worker’s comp 3 doctor practice.
A patient came in with a finger laceration from a metal cutting tool. It wasn’t bad enough to warrant stitches so I coded this as a new office visit 99203. In addition to the laceration, she said she did not know when her last tetanus shot was so we gave it to her (CPT code 90714 for the tetanus and 96372 for the injection. She also got some ibuprofen 400 mg. I then added a -25 modifier to the office visit.
The insurance company paid for the office visit, the 90714 and ibuprofen but is denying the 96372; saying the service represents an include component of the anesthesia package. Service denied.
I have looked in the CPT book and 96372 has nothing to do with a anesthesia package. I have always used 96372 in conjunction with 90714 but do not understand the denial. I have appealed twice and been sent back denied with no additional reimbursement.
Am I doing something wrong?
Thanks
Dave
E&M Outside of global OB package
Question: If an OB patient is seen for a visit outside of a routine visit but has a diagnosis code selected from the O category, would the patient’s EGA (27 wks) diagnosis codes need to be appended as well as the primary reason for the visit?
CPT 47564 Surgical Package
I want to know where in cpt 2016 code book I can find the surgical package for code 47564? I look in the biliary tract note section and I can not find the description of the surgical package. One of the rational in my CPC exam book state the procedure includes incision of the common duct to extract stones and the insertion of a T-tube that is brought out through the abdominal wall, but I do note see that description in the cpt code book.