Wiki coding microdebridements in office

[Dawn]

1. We are receiving global denials from Coventry when a pt has Septoplasty and Sinus surgery and they come back for debridements. Would you agree that the modify 79 would be good to use on the debridement?

2. If a patient just has sinus surgery only and the debridement in the office is denied for global would you use 58 modifier?

thanks
Dawn

 

[Kelly Taylor]

1st, what codes are you using? Secondly, the only way they can say the debridement is included in global is if they are relating this to the Septoplasty. The endoscopic sinus sx codes do not have any global days. Make sure your dx codes are linked correctly & if they won't accept the fact that the debridement had nothing to do with the septo, then have your doctor document the need for debridement regardless of septoplasty. Also, they shouldn't be denying the debridement as global after pt recv'd only sinus sx because these codes (31254-31288) do not have any global days.