Results 1 to 4 of 4

Medicare/global/24 modifier

  1. #1
    Default Medicare/global/24 modifier
    Exam Training Packages
    On 8/11/10 we preformed a nasal turbinate resection(30140). We saw the pt back in Sept for a follow up to the procedure. In October the pt came in with a nose bleed unrelated to the turbinate resection. The resection has a 90 global. I billed Medicare for the office visit in Oct and added a modifier 24 to indicate that it was unrelated to the procedure done in Aug. Medicare denied it anyways saying it was part of the post op period. What do you suggest I do? Do I appeal or will I just be hitting my head against the wall? I would have thought that 24 modifier would have been enough. Guess not.Thanks you for your advise.

  2. #2
    Location
    Brevard/Melbourne, FL
    Posts
    113
    Angry MC and modifier 24
    Quote Originally Posted by mmorneau View Post
    On 8/11/10 we preformed a nasal turbinate resection(30140). We saw the pt back in Sept for a follow up to the procedure. In October the pt came in with a nose bleed unrelated to the turbinate resection. The resection has a 90 global. I billed Medicare for the office visit in Oct and added a modifier 24 to indicate that it was unrelated to the procedure done in Aug. Medicare denied it anyways saying it was part of the post op period. What do you suggest I do? Do I appeal or will I just be hitting my head against the wall? I would have thought that 24 modifier would have been enough. Guess not.Thanks you for your advise.
    Did you have a different ICD-9 code for the October visit? Along with the -24 modifier? If so, I would still fight it out with them. As long as the physician documentation for the October visit states it was for a totally different reason from the surgery.
    Darcy Roy CPC

  3. #3
    Default
    I see these all the time & appeal them with medical records. Our Medicare contractor just has us fill out their redetermination form (noting the appeal request) & attach medical records for the visit being denied.
    We get paid no problem when appropriate & supported in records.

  4. #4
    Location
    Melbourne, Florida
    Posts
    124
    Default
    during a global period, may i code a 99213 -24 using an unrelated dx for the primary dx and the reason for surgery as the secondary dx.. or I am not aloud to use the reason for surgery dx on the claim at all when using the 24 modifier during a global period?
    Denise Gilrane-Pillow, CPB

Similar Threads

  1. Medicare 90 day global calendar
    By rjenn86 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 02-12-2014, 05:34 PM
  2. Which modifier during global
    By annielou in forum Modifiers
    Replies: 0
    Last Post: 12-03-2013, 12:34 PM
  3. Medicare Modifier for Global Period
    By rksaleh in forum Modifiers
    Replies: 5
    Last Post: 07-29-2012, 07:10 AM
  4. Medicare 3-day global
    By deonna774@hotmail.com in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 02-05-2012, 09:32 AM
  5. Billing Medicare in a global period
    By BillBair in forum Orthopaedics
    Replies: 6
    Last Post: 06-14-2011, 01:39 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.