Medicare Compliance & Reimbursement

Don't forget the 90-day global period on 46930. If your physician destroys internal hemorrhoids with heat, you changed your coding this year to rely on a code introduced in 2009: 46930 (Destruction of internal hemorrhoid[ s] by thermal energy [e.g., infrared coagulation, cautery, radiofrequency]). What may have been a surprise is that the new code treats the procedure as major surgery. Here's how to know: 46930 has a 90-day global period. So if your gastroenterologist performs thermal hemorrhoid destruction in stages, you'll have to append a modifier or risk losing as much as $189.71. American Society for Gastrointestinal Endoscopy adviser Glenn D. Littenberg, MD, American Gastroenterology Association adviser Joel V. Brill, MD, and American College of Gastroenterology adviser Daniel C. DeMarco, MD, foresaw this problem. They recommended modifier 76 (Repeat procedure or service by same physician) in the American College of Gastroenterology's 2009 CPT update. "It may be necessary to [...]