Wiki Global Billing Post Op

chewri

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Could you please tell me if you can bill a post op visit for gyn surgerys such as a 58558 or58662? Also in a pregancy when the urine dip that is in the global period tests positive for one of the elements can you bill for the urine dip?
 
58558 has a zero global period, so an e/m can be reported for follow up to that procedure. 58662 has a 90 day global so you cannot report an e/m for follow up.
The ua would still be inclusive of the OB visit regardless of abnormality. However if the abnormality requires a significant separately identifiable e/m, an e/m can be reported outside of the global. Some payors require modifier -25 for an e/m outside of the OB global.
 
annual exams

We are working with a new office so I do appreciate your input on these differences in billing.
Can you charge a Q0091(PAP COLLECTION) with the annual routine gyn exam?
When seeing a pregnancy initally calling it a amenorrhea visit but doing a sono, pap and cultures(or without cultures) then coming back for a new pregnancy discussion on which visit would the global period start?
Thanks again for your help
 
Q0091 depends on the insurance carrier.

For your second example - a couple things: If the first encounter is for a confirmation of pregnancy it should be coded with ICD-9 V72.42 (if positive). This can be coded as an e/m as long as the OB record is not initiated. Once the OB record is started, all other visits are included in the global with the exception of complications.
Hope that helps :)
 
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