Charging For 99024

whyteraven

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Hello everyone! I have a question...
I work with several different specialties and I've ran into a situation with post op visits. Appearantly, there are times that patients are seen and the offices mark them as post op (specifically 99024) and they are way past their post op period. This could be 4 months later when they only have a 90 day global. The situation I'm running into is that the person who sets up our computer software believes that the 99024 should be billed with a charge. In her arguement, BCBS has a fee listed with this procedure code, and if we were billing it out with a charge we would not be missing out on charges that are outside the global period by mistake.
I'm a bit concerned about weather this is fraudulent or not?? On one hand I understand her concerns about missing out on charges because the physician wants to no charge them and uses the 99024. On the other hand, couldn't this be considered "unbundling" the surgical package if we bill it within the post op period with a charge? I believe it should be up to the physician, or physician's office who did the surgery to be responsible for tracking their global days.

Confused and worried?? :confused:
 

Treetoad

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Our groups enter 99024 with a $0.00 dollar amount. We don't send a claim to the carrier, but we have it in the record for statistical information only.
 

Kris Cuddy

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It may be in the provider's best interest to speak with them about charging for visits that are outside of the global period. If they're not billing for them, they're losing out on money, no matter the amount.

I'm not sure what state you're in, yet in Michigan, BCBS does not pay for 99024. I'd be very leary about billing for a postoperative with 99024 and accepting payment unless I had a policy or agreement with a carrier in writing.

Hope this helps,

Kris
 

Treetoad

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If the service is outside of the "global period", why wouldn't you just charge a level? (99211-99215)
 
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San Diego
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Hi,

I've never worked with a Dr. (specialists included) who billed a 99024 with a monetary amount. (??) I can't think of anyone who does. It sounds like you're better off (or the person scheduling) keeping better track of the post op periods so you don't miss out on charging for e/m's when it is appropriate to do so. I know that some billing softwares have tools that allow you to set up internal "notifiers" that flag cpt codes with post op days.

Good Luck!
 

whyteraven

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Thanks all!!
My thoughts exactly!

I have NEVER worked with a company that puts a $$ amt to 99024. Usually it is given a $0.00 amt, not billed to insurance, and only used to help track the post op visits. I am in Arizona, and because my software IT person says that BCBS has a "fee schedule" amt listed that it should be programed into our system and billed out like any other charge. I don't agree!
I believe that the visits outside the global should be billed like any other visit, not utilizing the 99024 to try and "capture" these charges. Which is what they are trying to use this for. The offices should have a better way of tracking the global period for procedures, and better training should be done.
I just want to get others thoughts on this and obtain some info that I can forward to my manager to justify my arguement.
 
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What about other payers?

Is BCBS the only carrier you are billing to?
Why have a policy in place that is applicable to only one payer?
Our physicians use standard E/M codes for visits outside the global period.

F Tessa Bartels, CPC-E/M
 
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