Wiki Global office visits

[Peke]

30520 has a 90 global. Provider is also doing a FESS on same day of Septoplasty. Provider wants to know if he can charge for follow up visit due to it being related to the FESS not the Septoplasty.
Any documentation greatly appreciated.

 

[thomas7331]

In order to do this, you would need to bill the follow-up visit with a modifier 79 and be able to support it with documentation that the E&M service was unrelated to procedure 30520. I think this would be very difficult to justify since the procedures both likely involve overlapping anatomical areas, but it's hard to say for sure without looking at the records. I'd suggest reviewing the operative report and the documentation from the follow up visit and try to look at it from an auditor's perspective - does the documentation clearly show that the visit the provider wants to charge is unrelated to the post-operative care for the procedure that has the global period? Or if a payer denied the E&M charge, would you be able to write a persuasive appeal letter to explain why this was unrelated?

 

[Peke]

Thanks for your response . I just am struggling with a proper answer!