Wiki global denial bcbs

[TishCpc]

Can my dr bill a consult on 2/26/2016- 99254, and then on 2/27/2016 bill a subsequent. bcbs denied the consult as global. I am kind of confused because he performed the surgery on 2/28.

 

[avon4117]

it was probably included in the preoperative work up

 

[mhstrauss]

Can my dr bill a consult on 2/26/2016- 99254, and then on 2/27/2016 bill a subsequent. bcbs denied the consult as global. I am kind of confused because he performed the surgery on 2/28.

The usual (per CMS and CPT) global period for a major procedure is 1 day before the surgery, the day of the surgery, and 90 days following. The 26th in your example should not have been included. Check with that payer to see if their global rules are maybe a little different.

Also, which day was the decision for surgery made? Were both the 26th and 27th pertaining to the reason for surgery only?