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Old 05-11-2010, 07:13 AM
karenwelsh karenwelsh is offline
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Default 31237's done during global period

Is anyone having problems with reimbursements for this when a pt comes to the office after surgery? We aren't getting paid for these and some patient's are requiring 1-2-3 scopes after surgery -- ins co's are saying part of global.

I've heard that if you add modifyer 79, you'll get paid. We've re-filed with this modifyer and it's not helping.

Thanks for any advise from you more experienced coders out there!

Karen
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Old 05-12-2010, 10:07 AM
irvinme irvinme is offline
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Hi Karen,
Have you received any replies to this post? I am new to ENT and am questioning billing for endoscopies during the global period. Have you always billed for these and are just starting to get denials?
Thanks, Mary
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Old 05-12-2010, 03:01 PM
jthweatt jthweatt is offline
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After endoscopic sinus surgery (codes 31254 - 31288) we bill 31237 when appropriate with NO modifier because those codes have no global period. We do not have a problem with payment. Is the 31237 being bundled with another procedure by your insurance carrier?
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Old 05-19-2010, 08:34 AM
karenwelsh karenwelsh is offline
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No, nothing is being bundled when billing the 31237 -- only billing this code. We keep getting that this is included in global (?) -- I've just gotten certification and am stumbling thru this process, so I thank you for your response. We'll see what happens next time with no modifyer or any other CPT
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