Wiki PA billing 20552 within sx global

AmieM

Guest
Messages
4
Location
Williamson, NY
Best answers
0
Our office is mutli-specialty practice. There is a debate among the providers weather or not a PA can bill for an in office TPI inj 20552 within a 90day post op from sx. Billing manager says no, providers say yes, as long as they append the 24 modifier. Can someone help settle this debate?
 
Modifier 24 is for E&M codes, not for procedures. If the injection is being done during the global period, and the PA is acting on behalf of the surgeon who performed the 90-global procedure, then it would need to qualify for a surgical modifier - probably modifier 79 (unrelated to the surgery) - in order to be billed. In other words, it cannot be a treatment for a condition or complication that resulted from the procedure. (The other global modifiers 58 - staged procedure, and 78 - return to the OR, are not likely applicable in this situation.)
 
Top