31237 global to 30520??

mghughes

New
Messages
1
Location
Stapleton, GA
Best answers
0
Patient had a septoplasty in October (30520). Has had multiple debridements since that time and insurance is denying stating it is included in the global package. The 31237 is being submitted with -58 modifiers but are still not paying. I am wanting to appeal this decision but am having trouble finding the guideline showing that this is allowed for separate reimbursement. Can anyone assist?
 
Messages
212
Location
Niantic, CT
Best answers
0
Debridements for septoplasties (30520) are part of the 90-day global package, you can't bill for them. If you were doing the debridements for post-op endoscopic sinus surgery (eg, 31255, 31267, 31276, etc...), which have zero global, then you can bill for debridements (31237)

Jennifer
Coding Analyst
 

DawnB2019

New
Messages
6
Best answers
0
I am back into ENT billing/coding after many years and I have a question and am hoping someone can help me. I feel like I knew the answer at one time but honestly cannot remember. Patient has FESS surgery...including Septo/Turbs. They are billing 31231-79 during the post op period. Is this correct? The denial from insurance is invalid modifier. I know the Septo and Turbs have 90 day global.
 
Top