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The mystery of 31231 and the Global Period.

  1. #1
    Location
    New Port Richey & Gulf to Bay
    Posts
    107
    Question The mystery of 31231 and the Global Period.
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    Here is my situation!

    Patient is status post FESS.

    Patient returns for post-op follow up, and a diagnostic nasal endoscopy is performed.

    There is a debate amongst my office. Some say to apply a -58 or -79, while others are protesting it being charged.

    To note, there is no documentation of the endoscopy being staged.

    Does someone have an idea about this situation? If you do, please contact me through my work e-mail : KHonig@diagnosticclinic.net

    Thank you!

  2. #2
    Location
    New Port Richey & Gulf to Bay
    Posts
    107
    Exclamation Clarification
    Just to clarify to everyone. The endoscopy was performed to evaluate post procedural status.

  3. #3
    Default
    its considered part fo the gloval surgery... if the diagnose in other than what was used on the surgery then you can charge as a sep. f/u visit

  4. #4
    Location
    New Port Richey & Gulf to Bay
    Posts
    107
    Default
    Just what we though....thank you

  5. #5
    Location
    Capital City Coders
    Posts
    4
    Default
    hi,

    When we schedule a FESS, post operative debridments are a "staged procedure", meaning the phycisian expects there wil be scabbing & crusting that needs to be removed & up to 5 post op visits are scheduled. As long as the FESS is considered Stage I & no nasal surgery is done i.e. 30140,30465,30520 & on the post op visits only the procedure (31237-50-58) is billed no E&M is associated.

    tx deb

  6. #6
    Default
    FESS has no global period so debridements or diagnostic endoscopy need no modifier, 58 or 78, to be billable. In the case of patients who have septoplasty with FESS if debridement has to be done it is billable with a modifier 79 because the procedure is unrelated to the post-operative period for the septoplasty.
    Eileen Blankenship, CPC
    Remote Coder

  7. #7
    Location
    Salt Lake City
    Posts
    26
    Smile Evon Pefaur, CPC
    There is no global period for FESS. Whether billing post surgical nasal endoscopy 31231 or endoscopic debridement a modifier should not be required. If a septoplasty or SMR of inferior turbs is done at the same time you would need to append modifier 79 - endoscope is for the sinus procedure not the septoplasty so 58 is inappropriate. Good luck.

  8. #8
    Location
    Salt Lake City
    Posts
    26
    Smile Evon Pefaur, CPC
    There is no global period for FESS. Whether billing for post surgical nasal endoscopy 31231 or endoscopic debridement a modifier should not be required. If a septoplasty or SMR of inferior turbs is done at the same time you would need to append modifier 79 - endoscope is for the sinus procedure not the septoplasty so 58 is inappropriate. Good luck.

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