Wiki Cerclage removal

[TYSON1234]

Good afternoon, I received a denial for a patient that was seen in Observation and the decision was made to do a cerclage removal. I billed
99234, 57
59871
The insurance came back and said this service can't be billed separately. Am I missing something somewhere?

Thank you

 

[Cmama12]

There are a few reasons it could be denied. 57 mod would only apply to procedures with a 90-day global. 59871 has no global period. Was it done in the OR under anesthesia? Removed by same MD that put it in? Did she deliver - simple removal, (only local anes) is included in delivery - ?

 

[LRChilders]

If the removal of cerclage was completed under anesthesia, you can look into appending a -25 modifier to the E/M assuming documentation warrants the use of the modifier. If it was a simple cerclage removal (not under anesthesia) then the removal inclusive with the E/M reported. (Ex. OB patient at 37 weeks presented for a cerclage removal. Provider removes stitch, observes and discharges home.)

 

[TYSON1234]

There are a few reasons it could be denied. 57 mod would only apply to procedures with a 90-day global. 59871 has no global period. Was it done in the OR under anesthesia? Removed by same MD that put it in? Did she deliver - simple removal, (only local anes) is included in delivery - ?

It was done in the OR under anesthesia and no she didn't put the cerclage in (MFM did). Also, she didn't deliver, she went home the same day.