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Unrelated Service during PP period

  1. Default Unrelated Service during PP period
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    Our patient was diagnosed with Gestational Diabetes and Hypertension during pregnancy. 2 weeks PP she developed severe headache with nausea and vomiting and swelling. MD admitted her for observation, which I coded and added -79 modifier to. Claim was denied citing proceedure code and modifier were invalid for date of service. 99234-79. Please advise, and thanks for your help.

  2. #2
    Modifier 79 is for procedures only. Modifier 24 is for E&M serives that are unrealated to global package. Try billing it with mod 24.
    Brittany Purcell, CPC

  3. Default
    The presenting symptoms and encounter are belonging to the effects of Gestational hypertension which has its sequlae for 2 completed weeks and post partum eclampsia or its episodes still can occur any time from day one -during this period and the patient has come with all those associated symptoms So it can not be termed as unrelated service and that is why she was admitted for observation

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