Hello, Im curious if others are coding mastitis with an E/M and a 24 modifier in the pregnancy global period? If so, do you have any written documentation stating this is acceptable? TIA
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Wiki Mastitis in The Pregnancy Global Period
- Thread starter sclontz
- Start date
msjennings
New
Mastitis would be considered outside a normal/routine obstetric global period and separately billable with an E/M code, -24. Written documentation can be found within each payer's OB Policy.
nielynco
True Blue
If she is in the antepartum period, the modifier -24 cannot be used (the definition is unrelated E/M in the POSTOP period). If she has not delivered, she is not in the postop period. You can certainly code for the mastitis and if if is denied (and there was no additional prenatal care done at that visit) then appeal. Remember if there was addtional prenatal care at that visit to not count any of it toward the level of service,
lsilbaugh
Networker
If the patient has delivered and is in the 6 weeks post-partum. They developed mastitis, is that apart of the postpartum care in the global period, or would we apply an e/m visit with mod 24?
nielynco
True Blue
I would bill for the evaluation and care related to the mastitis. Do not count any care related to the normal 6 week visit when selecting the level of service, however.