Wiki questions regarding 20610?

[chase0702]

I got an EOB back from MED stating that this injection code (20610) was in the global period and was denied. I thought we could bill for the injection if it was in the global peroid??? Please help!

 

[nyyankees]

Was the injection done for post-op pain? If so that + the E/M be considered a part of the global period. Ortho-decisions Pink Sheets has a great article (by Margie Vaught I think) on this scenario of when it's appropriate to bill a 20610 in the global. Send your email and I will send to you.
KM

 

[chase0702]

jennifersteinbach@dpbsinc.com


Thank you so much

 

[malery]

You would need to use modifer 79 if indeed it was unrelated to the global period. Since 20610 is classified as a surgical procedure you would follow those modifier rules.
Melodie Alery, COSC

 

[leastham]

Could you also send this article to me. Medicare denied a patient for a 2nd injection and was wondering what modifier needed to be placed on there in ordr to get to to go thru.

thanks,
harley_lab@yahoo.ocm

 

[Resmondo-Williams]

Would you please send this article to me as well? cresmondo@floridaortho.com

 

[kathydaniel]

If you're giving an injection during the post op period for pain and the carrier follows Medicare's global surgical package, you can only bill for the medications not the injection itself. Medicare includs pain management in their global package.

If the carrier follows the CPT global surgical package definition, you can bill for the injection and with a modifier 58.

You may have to do some trial billings to learn which of your carriers follow which global definitions.

 

[laxmi]

Can this article be sent to me - laxmi@ehfs.net

 

[denarh40]

please send to denarh1967@hotmail.com also