Wiki Billing post op office visit when insurance denied surgery for no pre auth

[urbach34@yahoo.com]

I am coding for an orthopedic surgen who had a procedure (26055-Tendon Sheath Incision) denied by insurance for no pre auth. The office tried getting a retro auth but it was denied. My question is, if insurance is not going to pay for the procedure that would have put the patient into a global period, am I able to bill for the post op office visits?
The office manager feels that I cannot bill because the patient would still be in a global period from the hospital billing their part of the surgery.
Any input would be greatly appreciated!

 

[krisw7067]

No you can't bill during global, coding rules still state it has a global period even if patient insurance doesn't pay.

 

[urbach34@yahoo.com]

Thanks so much for the feedback!! I appreciate it