Wiki Global periods for multiple-session procedures

[rhotonscott]

So an ophthalmologist does a PRP-right eye (67228-RT). It states' one or more sessions' does that mean you can bill only once during the 90-day global period for this procedure? (Sometimes they will repeat the procedure until the microbleeds stop.) Does that also refer to the left eye PRP, or does it have it's own global period also???

 

[vpcats]

So an ophthalmologist does a PRP-right eye (67228-RT). It states' one or more sessions' does that mean you can bill only once during the 90-day global period for this procedure? (Sometimes they will repeat the procedure until the microbleeds stop.) Does that also refer to the left eye PRP, or does it have it's own global period also???

Did you get an answer to this yet?
PRP on one eye includes multiple times within the 90 day p/o period in that same eye (so yes, only one billing).

When you go to the other eye, you attach a 79 modifier to that IF you are still within the p/o period of the first eye. If not in p/o, then no modifier other than your LT or RT.

 

[rhotonscott]

makes sense- I have in my notes that if I use the -79 modifier on the procedure, then I use the -24 modifier on the E/M service. Is this correct?

 

[vpcats]

makes sense- I have in my notes that if I use the -79 modifier on the procedure, then I use the -24 modifier on the E/M service. Is this correct?

You only add the 24 to the E/M if you are in the post op period of the other eye's surgery (otherwise the E/M would be bundled into the other eye's post op term).
Now, if you do the E/M for the new eye, (to which you will add the 79 mod to the surgical procedure), remember to also add a 57 mod if this is the visit where you decided on the other eye's surgery and you're doing the E/M and the surgery is same day or next.