Wiki Global Period for 37765

[Mydream]

Have coded the patient's first procedure as an outpatient hospital claim with 36478 as the primary and also with 37765.
Patient returned two days later for another procedure and claim once again was submitted as an outpatient hospital claim with only code 37765.
The payer is now telling us that the second procedure is not payable as it falls under the global period.
I thought ALL outpatient procedures do not have any global period.
Guidance is appreciated.
Thank you.

 

[mhstrauss]

Have coded the patient's first procedure as an outpatient hospital claim with 36478 as the primary and also with 37765.
Patient returned two days later for another procedure and claim once again was submitted as an outpatient hospital claim with only code 37765.
The payer is now telling us that the second procedure is not payable as it falls under the global period.
I thought ALL outpatient procedures do not have any global period.
Guidance is appreciated.
Thank you.

No, there are many outpatient procedures that have a 90-day global period...37765 is one of them, per the RVU file.

Are you coding for the provider or facility?

 

[Mydream]

Will be coding for both the facility and the physician.

 

[CodingKing]

I'm still learning the facility stuff but I was reading that global period for an ASC facility claim is 24 hours but that some payers are 48-72 hours. I'm not sure if that's the issue. Depending on why the patient is coming back there may be a modifier that can be used.