In Coding
Aug 8th, 2018
Typical post-operative care, including related evaluation and management is not separately reportable; but, an unrelated evaluation and management service during a postoperative period may be. According to the Centers for Medicare and Medicaid Services (CMS), an E/M service provided during the global period of a procedure is unrelated if: • The E/M service is for ...
In Billing
Mar 1st, 2018
Is the caring for, and treatment of post-operative complications in the global period coded and billable?  To answer this question, You first must know who the third-party payer is because different payers have different rules. What’s the Global Issue? Medicare says they will not pay for any care for post-operative complications or exacerbations in the global ...
Payer rules differ with what’s considered an unrelated E/M service provided during the global period of a procedure. Typically, an evaluation and management (E/M) service provided during the global period of a procedure is not separately reimbursed, but is bundled into payment for the procedure. An exception occurs when the E/M service is unrelated to ...
Compare and contrast these modifiers to ensure proper use. Modifiers are necessary for complete and accurate coding. They convey important information about a claim and directly affect reimbursement. But choosing the most appropriate modifier can be confusing — especially when two or more modifiers have similar descriptors. For example: Modifier 58: Staged or related procedure or ...
In Coding
Oct 15th, 2015
Modifiers are the key to payment for surgical complications. The CPT® codebook and the Centers for Medicare & Medicaid Services (CMS) agree that a complication that requires a return to the operating room (OR) should be paid separately. For complications requiring additional surgical procedures in the OR that are related to the original surgery, append ...