Wiki Medicare/global/24 modifier

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mmorneau

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On 8/11/10 we preformed a nasal turbinate resection(30140). We saw the pt back in Sept for a follow up to the procedure. In October the pt came in with a nose bleed unrelated to the turbinate resection. The resection has a 90 global. I billed Medicare for the office visit in Oct and added a modifier 24 to indicate that it was unrelated to the procedure done in Aug. Medicare denied it anyways saying it was part of the post op period. What do you suggest I do? Do I appeal or will I just be hitting my head against the wall? I would have thought that 24 modifier would have been enough. Guess not.Thanks you for your advise.
 
MC and modifier 24

mmorneau said:
On 8/11/10 we preformed a nasal turbinate resection(30140). We saw the pt back in Sept for a follow up to the procedure. In October the pt came in with a nose bleed unrelated to the turbinate resection. The resection has a 90 global. I billed Medicare for the office visit in Oct and added a modifier 24 to indicate that it was unrelated to the procedure done in Aug. Medicare denied it anyways saying it was part of the post op period. What do you suggest I do? Do I appeal or will I just be hitting my head against the wall? I would have thought that 24 modifier would have been enough. Guess not.Thanks you for your advise.
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Did you have a different ICD-9 code for the October visit? Along with the -24 modifier? If so, I would still fight it out with them. As long as the physician documentation for the October visit states it was for a totally different reason from the surgery.
 
I see these all the time & appeal them with medical records. Our Medicare contractor just has us fill out their redetermination form (noting the appeal request) & attach medical records for the visit being denied.
We get paid no problem when appropriate & supported in records.
 
during a global period, may i code a 99213 -24 using an unrelated dx for the primary dx and the reason for surgery as the secondary dx.. or I am not aloud to use the reason for surgery dx on the claim at all when using the 24 modifier during a global period?
 
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