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Global Billing Post Op

  1. Default Global Billing Post Op
    Medical Coding Books
    Could you please tell me if you can bill a post op visit for gyn surgerys such as a 58558 or58662? Also in a pregancy when the urine dip that is in the global period tests positive for one of the elements can you bill for the urine dip?

  2. #2
    Greeley, Colorado
    58558 has a zero global period, so an e/m can be reported for follow up to that procedure. 58662 has a 90 day global so you cannot report an e/m for follow up.
    The ua would still be inclusive of the OB visit regardless of abnormality. However if the abnormality requires a significant separately identifiable e/m, an e/m can be reported outside of the global. Some payors require modifier -25 for an e/m outside of the OB global.
    Lisa Bledsoe, CPC, CPMA

  3. Default annual exams
    We are working with a new office so I do appreciate your input on these differences in billing.
    Can you charge a Q0091(PAP COLLECTION) with the annual routine gyn exam?
    When seeing a pregnancy initally calling it a amenorrhea visit but doing a sono, pap and cultures(or without cultures) then coming back for a new pregnancy discussion on which visit would the global period start?
    Thanks again for your help

  4. #4
    Greeley, Colorado
    Q0091 depends on the insurance carrier.

    For your second example - a couple things: If the first encounter is for a confirmation of pregnancy it should be coded with ICD-9 V72.42 (if positive). This can be coded as an e/m as long as the OB record is not initiated. Once the OB record is started, all other visits are included in the global with the exception of complications.
    Hope that helps
    Lisa Bledsoe, CPC, CPMA

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