# Global Billing Post Op



## chewri (Jan 12, 2011)

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?


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## Lisa Bledsoe (Jan 12, 2011)

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.


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## chewri (Jan 12, 2011)

*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


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## Lisa Bledsoe (Jan 12, 2011)

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


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