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I have code 99233 with modifier 25, being denied as global day period of codes 31645, and 31624. Some insurances pay, some don't. My question is are they suppose to pay? or is it proper to deny the line based on global day period?
modifier 25 is used for e and m services that happened the same day as a procedure or other service-if you are trying to unbundle an e and m from the global period that is unrelated to the procedure you should use modifier 24
31645 has no global period, so modifier 25 on the E/M is correct if done on the same date of service. You may want to check the guidelines for each insurance company, they don't all go by CPT guidelines. Some may require a different diagnosis on the E/M and some may not pay an E/M on the same date as a procedure.
There is a global period for this surgery. For those with the 000 indicator, The global period is the day of the surgery. E&M subsequent to the decision for surgery on the day before or on the day of is bundled. Although I would think the attending can still bill the subsequent inpatient visit even if there is a procedure on the same day. I'm not aware of anyone being admitted just for a minor procedure.