Wiki 31237 global to 30520??

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mghughes

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Stapleton, GA
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Patient had a septoplasty in October (30520). Has had multiple debridements since that time and insurance is denying stating it is included in the global package. The 31237 is being submitted with -58 modifiers but are still not paying. I am wanting to appeal this decision but am having trouble finding the guideline showing that this is allowed for separate reimbursement. Can anyone assist?
 
Debridements for septoplasties (30520) are part of the 90-day global package, you can't bill for them. If you were doing the debridements for post-op endoscopic sinus surgery (eg, 31255, 31267, 31276, etc...), which have zero global, then you can bill for debridements (31237)

Jennifer
Coding Analyst
 
I am back into ENT billing/coding after many years and I have a question and am hoping someone can help me. I feel like I knew the answer at one time but honestly cannot remember. Patient has FESS surgery...including Septo/Turbs. They are billing 31231-79 during the post op period. Is this correct? The denial from insurance is invalid modifier. I know the Septo and Turbs have 90 day global.
 
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