Coding question-Physician removed a nodule

Madcoder

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I'm stumped by this one, maybe someone can help straighten me out.

Family practice setting, Physician removed a nodule on patients back. Billed 11403. (Paid)

Patient returned 3 days later with a painfull abscess under right arm. Physician drained abscess. Billed 10060 (Mod 24). Denied. Global period.

I rebilled without mod 24 since this is a new, unrelated surgical procedure and submitted documentation and descriptive letter. (Denied) CPT is within the concurrent global surgical period of another procedure.

The dignosis codes and procedure codes are obviously different for each of the office visits.

Any advice. I'm a bit baffled with this one.
 

twizzle

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Coding question

I'm stumped by this one, maybe someone can help straighten me out.

Family practice setting, Physician removed a nodule on patients back. Billed 11403. (Paid)

Patient returned 3 days later with a painfull abscess under right arm. Physician drained abscess. Billed 10060 (Mod 24). Denied. Global period.

I rebilled without mod 24 since this is a new, unrelated surgical procedure and submitted documentation and descriptive letter. (Denied) CPT is within the concurrent global surgical period of another procedure.

The dignosis codes and procedure codes are obviously different for each of the office visits.

Any advice. I'm a bit baffled with this one.
For a start, why did you put a modifier 24 on the 10060? Modifier 24 goes on E&M codes only so it would deny. It would go on the office visit to assess the abscess along with a 25 modifier if he drained the abscess at the same visit. Since 10060 is unrelated to the original procedure, bill as 10060 -79.
99213 (or whatever level) -24-25
10060-79 (new 10-day global)

That should work.
 

Madcoder

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Thank you everyone. Extremely helpful. We are a solo practice and this is the first time this scenerio has risen. We do a few small surgical procedures per month, nothing back to back like this. Thanks again everyone.
 
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