Outpatient Facility Coding Alert

Reader Question:

Consider Modifier 79 for Unrelated Procedure Within Global Period

Published on Fri Feb 15, 2019

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Question: The provider performed a debridement endoscopy (31237) at a one-month check-up visit following a 31255, 31267, 30140, and 30520. May I bill for the 31237 since this still qualifies as the postoperative period?

Delaware Subscriber

Answer: The global periods for the original procedures performed are as follows:

31255, Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior) — 0 days
31267, Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus — 0 days
30140, Submucous resection inferior turbinate, partial or complete, any method — 0 days
30520, Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft — 90 days.

In order to report 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)) within the postoperative period of code 30520, you will have to confirm that the debridement is entirely unrelated to the septoplasty.

If you are unable to verify that the postoperative debridement is related to one of the surgeries with a global period of 0 days, then you should not consider billing 31237 separately. However, if there is documentation to support that the debridement is unrelated to the septoplasty, you may report 31237 with modifier 79 (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period).