Urology Coding Alert

Question: Should you bill for a PVR during the global of a 90-day global procedure, like a prolapse repair? If so would you bill it using a modifier 58 or 79? My urologists are doing this on all patients post operatively to make sure they are emptying. I feel like this might be part of global but don’t want to miss billing if it is reimbursable.

New York Subscriber

Answer: Most payers (if not all payers) would consider this an unbillable service because the sonogram is being performed on all cases whether there are medical indications or not. This diagnostic study is being performed routinely as “a standing order” without medical necessity, and thus would be considered a screening test for which no charge should be made.