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included in global??

  1. Default included in global??
    Medical Coding Books
    I'm feeling stupid this morning.

    Can anyone help me out:

    One of our doctors saw a patient in the hospital while she was on call; this patient was admitted for asthma but was pregnant too. She was admitted on 12-16, delivered via C-sect on 12-18 (59514), and was discharged 12-22.

    the insurance is denying 99232 from 12-18 and 99238 from 12-22 stating they are included in the global proc. Can the doctor not charge for seeing the patient these days since she did the C section?

  2. #2
    Kansas City, MO
    The only way you might get reimbursed is if the documentation for the 99232 shows a clear decision for surgery. We had a similar case and the patients condition had begun to deteriorate which necessitated the need for the C-section. We billed it with the modifier -25 since the 59514 has no Global days. As for the discharge, I would appeal based on the grounds that the delivery only code does not have global days and the discharge should be reimbursed.
    Angela Jordan, CPC, COBGC, AAPC Fellow
    Senior Managing Consultant
    Medical Revenue Solutions, LLC
    AAPC National Advisory Board - Southwest
    AAPCCA BOD Chair 2012-2013

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