Hello: I received this newsletter via email. See below.

I would like to verify that this statement below is correct! Why could you not add mod 78 to the 33215. I can not find anything that states a physician can not bill for a lead reposition if done during the global period. It use to you could not bill with 15 days after primary procedure. In the 2010Principles of CPT Coding, it does not state that you can not code 33215 mod 78.

Any input would be appreciated!


The bottom line is that physicians and hospitals have separate rules regarding what is separately billable. For example, take the case of a patient that has a dual chamber cardiac defibrillator implanted as an outpatient procedure on day one (33249). On day two the patient returns with a dislodged lead and the lead is repositioned. CPT code 33249 has a 90 day global period for physician billing. The physician cannot bill separately for repositioning the lead (33215) as it falls under the category of “additional medical or surgical services required of the surgeon during the postoperative period of the surgery because of complications which do not require additional trips to the operating room”. The hospital, however, can bill separately for the repositioning as the hospital is not subject to global surgical packaging.