Wiki Global Period ASC

[fredmax3]

I work in an ASC that does cataract surgery we have been getting some denials from Medicare Advantage policies for billing within the global period for the same procedure but the surgery is on the second eye. Is there a global period for surgeries done in a ASC on the same procedure for 2 different eyes?

Thank you

Mindy

 

[iowagirl77]

If the second surgery is on a different eye it is considered unrelated to the first eye surgery, so you should be able to add a 79 modifier to the second surgery.

 

[thomas7331]

Global periods are a physician/professional reimbursement policy only and should not apply to facility claims. If they are denying the facility claim, this is an error, but if it is a professional claim, then a modifier is necessary and 79 should work to indicate the procedure is unrelated since it is not on the same eye.