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Wiki Post Op Vs Follow up

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1
Location
San Antonio Texas
Best answers
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Hello,
I work for an ENT specialty. We recently discovered that BCBS will not pay for our 69440 when billed with the 69801. We usually bill them out as such:
69801
69440-59
69433-59

However, BCBSTX doesn't like this & will only pay for the 69801.

My provider has now requested that I go back and change the zero charge Post Op visits to follow up visits, since the charge with the global period (69440 has a 90 day global) was denied. So any visits afterward should have been regularly billed.

Are there any ethics or constraints against this? I have searched and cannot find anything, but it doesn't seem like this should be appropriate, especially if our documentation states it is for a Post Op visit.

Any guidance would be greatly appreciated.
 
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