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Global Days for Unlisted Codes?

  1. #1
    Default Global Days for Unlisted Codes?
    Medical Coding Books
    I had to use an unlisted code for an internal hemorroidectomy (46999). Hemorrhoidectomy codes usually have a 90 day global but since I'm using an unlisted, should I charge for the post-op visits?
    Sue Vermette, CPC, CPMA

  2. #2
    Default You can bill for post op visits
    Flashcode gives this for global surgical period, "XXX=The global concept does not apply to the code."

    You would be able to bill for post op visits based on this.

  3. #3
    I think if the insurance company pays you at a rate that is consistent with a similar 90-day procedure, then you should treat it like a 90-day procedure. That's another reason why it's important to track payments for unlisted codes. You should have an idea of what would be fair for the services rendered (including post-op care) and if not paid to your expectations, you need to appeal. I do this quite often and am very successful. Also, from a patient's point-of-view, it wouldn't be fair to them to get bills for co-pays for post-op visits. Good luck.

  4. #4
    Milwaukee WI
    Default I agree w/ Erica
    Very well said, Erica! I completely agree.

    F Tessa Bartels,CPC, CEMC

  5. #5
    Default Appeals
    Thanks for the advice. Erica, when you appeal something like this, do you state that you're seeking compensation that reflects a global period? Since Medicare assigns "global concept does not apply" to unlisted codes, do you appeal those too to make them apply the global concept?
    Sue Vermette, CPC, CPMA

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