post ops for different global periods

Tbarnaby

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Hello,

Very frequently with my docs patients will have a combination of a septoplasty and a FESS. I am seeing a volume of patients being billed established patient office visits with a 24 modifier, and the dx codes are for the FESS. These visits are taking place within the 90 day global of the septoplasty, and yet they are not mentioning this procedure in the note.
I am wondering if they really don't require post-op care for a septoplasty, or they are trying to get around the global. Any help would be appreciated.
 

prince21

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Without more specifics regardingt the type of FESS, I suggest that you talk with physicians to clarify the reason for the post op visit. IF it is a post op visit for both of the procedures then this would be considered in the global and not billable as a separate visit.
 

eblanken

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Not sure about anyone else but that screams false claim to me. There is a 90 day follow up period for a septoplasty (30520) so unless the patient presents with an unrelated condition to the septoplasty & fess than I would say it is inappropriate to bill the e/m with modifier 24.
 
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Milwaukee WI
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I agree

I agree with Eileen. This seems to be part of the post-op care.

And if they AREN't providing ANY post-op care for the septoplasty, did they use a -54 modifier on the procedure?

F Tessa Bartels, CPC, CPC-E/M
 
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