Wiki 45100 and global period

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bridgettemartin

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Our pediatric gastroenterologist performed rectal suction bx, which carries a 90 day global. (Hirschprung's was neg). The patient came back for an office visit one month later, when their constipation recurred. The office visit was denied d/t the global period. Our provider states in the note that the patient's constipation has recurred and is ordering other tests. We are also treating the patient for GERD, and new Rx were ordered for that. But, the primary reason for the visit was the constipation.

When I look at modifier -24, it deals with reasons unrelated to the original procedure.

Do we have any other options?

Thanks!
 
If the CC for the follow up visit is related to the reason for the surgical procedure, then global rules. And if you now appeal for unrelated dx, insurance will probably deny again, unless there is significant documentation to support the e& m with mod 24.
 
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