Can we use Modifier 57 on a hospital E&M when also performing procedures with 90 and 10 day global periods?

[aalley]

Does anyone know where I can find information addressing this situation? We billed 99223 with modifier 57 on the same day as 15004 (90 day global) and 15260 (10 day global). Insurance initially paid on the E&M but are now taking it back saying it cannot be used with a minor procedure (15004). I need to know if I can fight this since we also have a 90 day procedure on the claim.

 

[ccallycat]

I've had that happen before, cant remember which insurance company (one of the major ones), but I had to put both mods on there, 25 and 57. Had to submit it as a corrected claim, and they reprocessed and paid both codes. I think their system just knows there's a 10d global and only wants a 25 mod for that.

 

[aalley]

I've had that happen before, cant remember which insurance company (one of the major ones), but I had to put both mods on there, 25 and 57. Had to submit it as a corrected claim, and they reprocessed and paid both codes. I think their system just knows there's a 10d global and only wants a 25 mod for that.

Thank you for the advice.