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Usage of Modifiers During Global Period

  1. #1
    Default Usage of Modifiers During Global Period
    Medical Coding Books
    If a patient has had I&D done at another facility and they come in due to a condition related to the I&D and it's still in the global period what modifier could I use to bill the EM?

  2. #2
    Default
    I believe that you could use a -55 ("postoperative management only") on the procedure, depending...though the billers in my office say it will likely be denied and need to be submitted with notes (the original procedure is rarely, most likely, submitted with a -54), though likely to be denied again.
    If the procedure had to be repeated, a -77 ("repeat procedure by another phys.") on the procedure code may work, though I've not had the opportunity to use it before.

    anyone back me up or set me straight?

    i would also check in the E/M forum and in the "global period" discussion...depending on what the "condition" is, or the who/what/where of the scenario, those posts may help.

    good luck!
    Last edited by spstarke; 02-04-2010 at 01:24 PM.

  3. #3
    Location
    Greater Portland (Maine)
    Posts
    129
    Default
    Modifiers 54, 55 and 77 are only used on procedures. You asked what modifier to use on the E&M code. Since your physician didn't perform the I&D, there is no global period for him/her; therefore, no modifier is necessary. If he/she repeated the I&D, then modifier 77 would be appropriate.
    RCBartholomew, CPC-H, CEDC

  4. #4
    Default
    Oh okay.. Thank you I guess I was just over thinking it...

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