Wiki Help-CPT 10060 global period

[ralcanta]

Patient was seen at the office 09/16 and came back again on 09/26 with the same procedure.

09/16: 99213 -25, 10060 Dx:682.9 UNSP CELLULITIS/ABSCESS Paid
09/26: 99212 -25, 10060 Dx:682.9 UNSP CELLULITIS/ABSCESS Denied


Since was billed 10 days after, insurance still denied 09/26 as part of global package.
09/26: Notes only state F/U to abcess 09/16 Left underarm ok, but Right underarm not improved much, repeat 10060. So it was unplanned procedure can we add modifier -78? or a repeat procedure can we add -76 to 10060?

Are we allowed to bill the E/M code 99212?

 

[dclark7]

From your post it's hard to tell if the original procedure was done on the right or the left or both sides. This is important to know in order to determine the correct modifier.

 

[ralcanta]

The procedure on 09/19 was done on Both (RT/LT)
The procedure on 09/26 assesment plans states: F/U on abcess, I+D to R,L Axilla.