Part B Insider (Multispecialty) Coding Alert

Question: A patient comes in and has 17 lesions treated. I see that 56501 has a global classification of 10 days. Unfortunately, the ob-gyn is going out of town and has the patient returning before she leaves (seven days after the first treatment). The ob-gyn re-evaluates and decides more cryo is needed for missed lesions. Is this still part of the global period?

Answer: No, the second bout of cryotherapy would not be part of the global period. You should report 56501 (Destruction oflesion[s], vulva; simple [e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery]) with modifier 76 (Repeat procedure or service by same physician or other qualified healthcare professional).

Remember: You should count the visit portion as part of the global period. Modifier 58 (Staged or related procedure or service by the same physician or other qualified healthcare professional during the postoperative period) would not work unless the second procedure was more extensive than the first (which it was not) or the ob-gyn planned the second procedure at the time of the first cryo.