Wiki Global and injections

[gmitch02]

I hope you all can help - Our Doctor does a surgury with a 90 day global (29875) the patient follows up in office and our doctor gives an injection 20610 with J3301 - same Dx are used. It is kicking out for global. Is this something he can get paid for? Thank you for your help.

G. Mitchell

 

[HeidiLynn]

This would be considered part of the global package same knee, same dx, realted to surgery. You would be able to get reinbursment if it was a different problem not realted to the surgery with a mod 79. or a different knee of course.

 

[RGALVEZ]

You can get paid for the 20610 and the J3301 by adding the Modifier 58 to the 20610. The E&M will not be able to be billed if for the same DX as the Sx. Hope this helps.

 

[Lisa Bledsoe]

If this is a Medicare patient it is part of the global. Medicare only pays for a return the the OR.

 

[gmitch02]

Thank you all for your response.

G.Mitchell

 

[mbort]

You can get paid for the 20610 and the J3301 by adding the Modifier 58 to the 20610. The E&M will not be able to be billed if for the same DX as the Sx. Hope this helps.

58 would not be an appropriate modifier unless this was a staged type injection.

I agree with Lisa, Medicare does not allow unless patient returns to the operating room, this info can be found in the NCCI guidelines. Since most carries claim to follow these guidelines (only if its in their favor of course) I think you may have problems getting paid for this unless you can prove that its not related to the surgery.

just my two cents