64622 medicare denial

larkatin

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We billed Highmark Medicare for 64622 RT, 64623 x 3 RT for a 2/18/09 date of service. Pt returned and had 64622 LT, 64623 x 3 LT for 2/27/09. Medicare paid the 1st DOS and denied the 2nd as "payment included in the allowance for another service". I appealed, included copies of dictation for all dates of service, noting the Right & Left in particular. I received a 2nd denial as within the global period. What am I missing? Does the global period for the right side include any services done to the left side? Thanks ahead for any direction!
 

Chronicles Billing

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Locust Grove, GA
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64622 denial response

I did not see any mention of modifier "78" to indicate to the Third Party Payer that the patient returned to the operating room for a related procedure during the "postoperative period".


Chronicles Billing Inc.
 
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