Wiki Global???? not paying for exam with procedure

[splaineduchsherer]

Hi All,

I am having an issue with insurances, mostly medicare not paying for an exam when a patient comes in for 97597. We have patients that develop new ulcers and the doctor has to check for other areas developing. Now they say it is global

AND now when patient comes in weekly for ulcer check and we charge out an office visit they are denying for global

Anyone have any ideas

 

[desalsbury]

97597 does not have a global, I am guessing you had a procedure code prior to this DOS that did have a global, look back in the chart for this and if that is the case you will need modifiers on debridement code and the OV if just for recheck/not new problem or separately identifiable is included in the global and should not be paid. Without having all the info this is where I would start from the information you have provided.