Wiki LCD question

[herrera4]

for LCD for 46930-it states there is a global period of 90 days and no procedures may even be billed with modifier 58 during this time. I just need to verify that if a patient signs the ABN during this time-is the patient billiable if another 46930 is done during this 90 days? Or no, because its not denied due to medical necessity?
Thank you

 

[ajs]

for LCD for 46930-it states there is a global period of 90 days and no procedures may even be billed with modifier 58 during this time. I just need to verify that if a patient signs the ABN during this time-is the patient billiable if another 46930 is done during this 90 days? Or no, because its not denied due to medical necessity?
Thank you

You may not bill the patient for a second procedure 46930 as it is considered part of the initial procedure. An ABN does not apply because this procedure is covered under the restrictions set down in the LCD. The LCD states that 46390 is covered one time only no matter how many sessions may be required in the 90 days global. In fact, if the 46390 procedure does not eliminate the problem they recommend a different type of procedure be used after the 90 day global.

 

[herrera4]

thanks for clarification-i think i confused myself when i read the Article for LCD, and it had the ABN instructions on it . Thank you!!