Wiki same procedure, same provider within 90 day global

wavingwheat

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Physician performed a transurethral resection of postoperative bladder neck contracture, 52640. Less than 90 days later, the same provider performs the same procedure. Even though CPT does not say modifier 76 is for same day procedure, that seems to be the interpretation. So do I code 76 or maybe 78? The insurance is Cigna.
 
That's a very good question.
So here is the deal with reporting surgical global period modifiers that technically unbundle the procedure at hand from which ever procedure the patient is currently within the major global period for (90 days).
Accurate and thorough Medical Record review are everything in these instances, we can't disseminate which global period modifiers to append unless we have the operativ report for the current procedure. I would also grab the note from tthe prior Transurethral Resection to determine what diagnoses and conditions the patient had during that Operation as well as to see if there were any intraoperative complication at that time, if the physician planned on performing a staged procedure over a prescribed period of weeks or months -modifier 58 for staged. Which I am not assuming whichodifier would be used at this time as we need the op note, you can message it to me if you want minus the PHI of course. Also there is modifier 79 for unrelated separately identifiable procedure performed in the global period of another major procedure. You can report 79 for a multitude of cases just depending on t he documentation.
Erik Brown, CIRCC, CPC
Email:erikbrown619@yahoo.com
 
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