Wiki coding 64585 within the 10 day global period

[djcjr5]

We bill 64561 for the percutaneous implantion of an electrode array. The patient always comes back to have it removed, as it is temporary, during the 10 day global period. According to AUGS, this is not separately coded as it is typically done within this time frame. The doctor and my supervisors insist that we bill this. I say we shouldn't, but the other coder in the office will bill 64585-58 and it gets paid. I would like to hear how others handle this, and if she is correct on adding the modifier to get it paid.

 

[csperoni]

AUGS has an article that exactly answers this question.
https://www.augs.org/assets/1/6/Coding_Fact_Sheet_for_Sacral_Neuromodulation_2018.pdf See page 4 and also page 7 Billing examples Q1.
The removal is not separately billed per their advice.
The argument that someone else billed it and it was paid does NOT mean it is correct coding. It simply means the insurance does not audit every record, and did not realize this incorrect bill.