Wiki IMTERSTIM Reprogramming In 90 Day Global!

[gabrielmartinez]

Question: we contract out to Medtronics Interstim Rep/Provider for Imterstim Programming, implantation Ect.., pt comes in for reprogramming with in the 90 day global of (64581 64590 and 95972) can we bill 95972 when Pt presents in global ?

 

[martinni1974]

**Re-programming of the interstim generator is an anticipated and planned (staged). Appending modifier 58 to the applicable re-programming code is appropriate in the global period. You would not bill for an E&M however in this scenario unless of course there is some unrelated issue going on, just the re-programming.[/COLOR]
Understanding the definition and applicability of modifier 58 is a key to accurate coding during the global period. Its proper use will also reduce your risk of an audit during the global period.**

Defining Modifier 58
Modifier 58—staged or related procedure or service by the same physician during the postoperative period—is used to report a surgical procedure that is staged or related to the primary surgical procedure and is performed during the global period. It is most commonly applied in the following instances:

•The second procedure is anticipated or planned to manage the underlying condition.
•A second, more extensive procedure is needed to treat the underlying disease process.
•A therapeutic procedure following a surgical procedure is planned.
Modifier 58 may be appended to surgical CPT codes in any place of service, assuming that the second or subsequent procedure is staged or anticipated, planned, or more extensive than the original procedure.

The global period restarts with the subsequent procedure, and the surgeon should receive 100 percent of the allowable reimbursement on both the first and the subsequent procedures.

 

[martinni1974]

Just to clarify.....as long as your physician is performing the re-programming.