Need feedback, please

b10sliger

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Scenario: Pt has proc that has 10 global. Pt comes in on the 5th day; doing fine post proc, but has new c/o pain in different area.

Claim was filed for OV level 3; insurance paid. Now they are asking for refund. Supervisor wants to re-bill w/mod -25 on E/M code. I say it should have been billed as post-op f/u [99024] w/post-op dx [V58.72] + 99213-25 w/live code dx for pain [721.3]
 
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