Diagnostic laparscopy

maine4me

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Yesterday in a meeting with our general surgeons the question was raised as to the post-operative period for a diagnostic laparoscopy. I advised them that this has a 10 global period.
Today, I got an email from one of the surgeons in which he indicates that he thought for "non-treating" procedure where the underlying problem is not addressed or corrected he thinks it is appropriate to bill for a visit during the post-operative period. I have been unable to find any information supporting this. I have considered that possibly this was how it used to be and that the post-operative period may have changed.
Any help will be appreciated.
 

koatsj

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A diagnostic lap does have a 10 day global. I am not sure what your surgeon is referring to. Regardless of if something was found or not, the procedure was still done. Trocars were used and incisions were made. Good luck :D
 

Lujanwj

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I'd reference CMS' Claims Processing Manual Chpt 12 so they can see the rules for themselves.

Here some import quotes.

Modifier “-24”:
Reports an unrelated evaluation and management service by same physician during a postoperative period. The physician may need to indicate that an evaluation and management service was performed during the postoperative period of an unrelated procedure. This circumstance is reported by adding the modifier “-24” to the appropriate level of evaluation and management service.
Services submitted with the “-24” modifier must be sufficiently documented to establish that the visit was unrelated to the surgery. An ICD-9-CM code that clearly indicates that the reason for the encounter was unrelated to the surgery is acceptable documentation.
......

Carriers do not allow separate payment for evaluation and management services furnished on the same day or during the postoperative period of a surgery if the services are billed without modifier “-24,” “-25,” or “-57.” These services should be denied. Carriers do not allow separate payment for visits during the postoperative period that are billed with the modifier “-24” but without sufficient documentation. These services should also be denied. Modifier “-24” is intended for use with services that are absolutely unrelated to the surgery. It is not to be used for the medical management of a patient by the surgeon following surgery.

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads//clm104c12.pdf
 
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