Urology Coding Alert
Check Global Period Before Coding 51040
Question: If a patient has an SP tube placement (51040) and comes in monthly for tube changes, can we bill for the changes? I’ve been told to add a 58 modifier, but I’m not sure that is appropriate. The patient is non-Medicare.
Oregon Subscriber
Answer: If the change of the tube falls within the 90-day global of the open suprapubic placement, you should code a replacement of the tube with either 51705 (Change of cystostomy tube; simple) or 51710 (... complicated). Add modifier 58 (Staged or related procedure or service by the same physician or other health care professional during the postoperative period) to 51705 or 51710 since this placement is related to the original procedure.
Pointer: Suggest that your urologist add a note to the operative report that states “the suprapubic tube will be changed monthly during the global period as a staged or related procedure and also monthly thereafter.”
If your urologist placed the tube after the 90-day global period, you will report 51705 or 51710 with no modifier attached.
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