Wiki Hysterectomy done within global period for 57520

[cgarciamck87@gmail.com]

Good morning everybody. So patient underwent a cone biopsy (57520) back in May of this year. This was billed and processed. Then in July, she came back for a hysterectomy with bilateral salpingectomy, and repair of cystocele. This was billed as 58262 and 57240-51. We received a denial for services having been provided during the global period for the cone biopsy. Would I need to do something different when billing the most recent procedures?

 

[Cmama12]

Hi, you will need to add the appropriate modifier. Is the hysterectomy related to the biopsy? - if yes, a 58, if no, a 79. the 57240 would need a 79

 

[cgarciamck87@gmail.com]

Hi, you will need to add the appropriate modifier. Is the hysterectomy related to the biopsy? - if yes, a 58, if no, a 79. the 57240 would need a 79

Hi. Thank you for replying. So from the notes I'm reading, the hysterectomy and salpingectomy were recommended after the pathology report from the cone biopsy showed adenocarcinoma in Situ. I'm assuming that the modifier to be used then would be 58.

So I would need to send a corrected claim to add the modifier or how exactly would I go about this? I had yet to come across this type of situation where these types of procedures were done within the global period.

 

[Cmama12]

Hi. Thank you for replying. So from the notes I'm reading, the hysterectomy and salpingectomy were recommended after the pathology report from the cone biopsy showed adenocarcinoma in Situ. I'm assuming that the modifier to be used then would be 58.

So I would need to send a corrected claim to add the modifier or how exactly would I go about this? I had yet to come across this type of situation where these types of procedures were done within the global period.

Yes, in that case I would use the 58. Sorry I don't really know much about sending out claims.

 

[csperoni]

Hi. Thank you for replying. So from the notes I'm reading, the hysterectomy and salpingectomy were recommended after the pathology report from the cone biopsy showed adenocarcinoma in Situ. I'm assuming that the modifier to be used then would be 58.

So I would need to send a corrected claim to add the modifier or how exactly would I go about this? I had yet to come across this type of situation where these types of procedures were done within the global period.

Regarding submitting a corrected claim, each carrier sets their own policy about how this should be done. Absent carrier guidance, I would submit a copy of the denial, appeal letter explaining, and a corrected claim. Most carriers even have ways to submit a corrected claim electronically.