Wiki Billing 31237 for removal of silastic sheets/splints

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carmanbrad15

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My ENT is wanting to code for the removal of the silastic sheets/splints within 2-3 weeks after surgery. He is doing the following surgery: 31288 30520 31255 31267. I do realize that 30520 has a 90 day global. I have read that the septoplasty includes removing the silastic sheets within 2-3 days. I am thinking he is trying to code for something which is global. But I need proof to show him this. Any suggestions?
Thanks,
Carman Wilson CPC, CPMA, COBGC
 
Dear Carman, The proof you seek is in Medicare's definition of the "global period"; "the global period is the time follwoing a surgery during which routine care by the physician is considered post-operative and included in the surgical fee; office visits or other routine care related to the orginial surgery cannot be separately reported if the occur during the global period".

CPT 30520 has a 90 day global period, the placement of stents is something that routinely takes place when septoplasties are done and the removal of them post-operatively is expected, whether it is 2-3 day post op or 2-3 weeks; you should not charge for the removal, you certainly cannot bill CPT 31237 as it is not applicable to stent removal; if it regarding sinus debridement post-operatively, then it is billable.

Hope this helps.

Jennifer
CT ENT
 
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