Global period injections

rowaymat

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Hello all,
If a patient is in the global period and has an injection b/c of pain related to the surgery, not an aspiration, can't I bill the injection with a 58 mod? Most people say it's bundled but I don't see why especially with the descriptoin of mod 58. I have gotten so many different answers on this one from co-workers, physicians, and list servs that it's confusing the crap out of me. If you have a link to go with your answer that would be great. Thanks for the help.
 

mbort

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I say yes (there will be people that will strongly disagree with me on this)

My thought process is that it is not the "norm" to have to have an injection post operatively, days after surgery, so providing the documentation supports it, I would code the 20610-58 with the appropriate dx codes.
 

RebeccaWoodward*

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Mary,

You are very knowledgeable in your field and I truly respect your post's. Your answer intrigued me. We have received denials in the past for this scenerio. Have you been successful appealing these or did your insurance carriers simply pay with modifier 58?
 

mbort

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Its a combination of both Rebecca. It really varies from carrier to carrier. For those carriers that choose to deny them without having requested medical records, I will have the collections department appeal it, I will assist them with the letter and give them the documentation to support and send it with it. Sometimes we win, sometimes we lose....but I do make sure that the carrier can back up their denial with supporting evidence. I will fight them to the bitter end

and thank you..I appreciate and respect your posts as well :)
Mary

Mary,

You are very knowledgeable in your field and I truly respect your post's. Your answer intrigued me. We have received denials in the past for this scenerio. Have you been successful appealing these or did your insurance carriers simply pay with modifier 58?
 

RebeccaWoodward*

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Thank you, Mary~

You have really given me something to think about. I must say... it is so nice to have such a great network of colleagues who share the same passion.

Take care,
 
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