pre-operative visit within a global period for related procedure

[jocarter]

If the patient had a partial removal of colon with colostomy and is still within the 90- day global period, can/should the same physician bill for the pre-operative visit prior to the colostomy reversal? It feels like this should just be a 99024 post op visit but another coder is telling me we MUST bill the pre-op with modifier 24?

Does anyone have a link to an article on this topic that they could share? I can't seem to find any example like this....

any help would be greatly appreciated

Thanks

 

[thomas7331]

I think the CMS guidance is pretty clear on this: "Medicare includes the following services in the global surgery payment when provided in addition to the surgery: Pre-operative visits after the decision is made to operate. For major procedures, this includes preoperative visits the day before the day of surgery. For minor procedures, this includes pre-operative visits the day of surgery." As I read it, a pre-operative visit is always inclusive to a global period unless a decision for a major surgery is also being made at that visit. (see https://www.cms.gov/Outreach-and-Ed...oducts/downloads/GloballSurgery-ICN907166.pdf)

Unless for some reason the physician had not made a decision to reverse the colostomy at the time of the pre-operative visit, or unless there was some new or unrelated problem or change in the patient's condition that was addressed at the visit, I don't see how a modifier 24 would be supported and agree with you that this should be a no-charge visit.