Wiki Myringotomy without tube

[njbrown]

If a patient comes in and has a myringotomy without tube (69420) then comes back in before the global days in and has Myringotomy with tube (69435) in same ear. Can the doctor also charge for another office visit or would you just charge the procedure with a modifier? According to note pt was coming back for recheck and wanted tube placed.

 

[thomas7331]

Since the placement of the tube is a more extensive procedure than the original one, I would bill it with modifier 58 as it meets the definition of a staged related procedure. (I'm assuming you mean 69433 or 69436 instead of 69435 which is not a valid code.)

If you are in the global period, you would not bill an office visit unless the documentation of the E/M supports both modifiers 24 and 25 (both of which would be required here) for significant services unrelated to the procedures.

 

[njbrown]

Since the placement of the tube is a more extensive procedure than the original one, I would bill it with modifier 58 as it meets the definition of a staged related procedure. (I'm assuming you mean 69433 or 69436 instead of 69435 which is not a valid code.)

If you are in the global period, you would not bill an office visit unless the documentation of the E/M supports both modifiers 24 and 25 (both of which would be required here) for significant services unrelated to the procedures.

yes the code I was talking about was 69436. thanks