Any thoughts on this would be much appreciated.
We have received several denials for subsequent hospital visits as "“Pre/post-operative care payment is included in the allowance for the surgery/procedure.”
Patient had a biopsy of a mediastinal mass performed using the chamberlain procedure 39010, which has a 90-day global. Patient remained in the hospital and received Chemo the following days after. Surgery/biopsy was performed by our Thoracic MD and the follow ups were by our MED Onc MD's (two separate sub specialties).
1. Should/Can I append mods to the hospital visits? The visits did not go out with any modifiers. I feel like it needed mods since patient received chemo, which would prompt the above denial. Same denial we get if a regular E&M goes out without a mod 25 and injection/infusion done same day.
2. Are these visits considered a part of the global surgical package (because the biopsy came back malignant which is the reason for the chemo) or is it separate since the visits relates to the chemo and not the surgical procedure itself, and it is a separate MD/subspecialty seeing the patient in regards to the chemo.
I over all feel like these visits need mods, but am unsure if it needs only a 25, a 24 and a 25 or a combination of mods im missing all together or if these are just all inclusive to the global period and we have to write off.
Your help is much appreciated.
We have received several denials for subsequent hospital visits as "“Pre/post-operative care payment is included in the allowance for the surgery/procedure.”
Patient had a biopsy of a mediastinal mass performed using the chamberlain procedure 39010, which has a 90-day global. Patient remained in the hospital and received Chemo the following days after. Surgery/biopsy was performed by our Thoracic MD and the follow ups were by our MED Onc MD's (two separate sub specialties).
1. Should/Can I append mods to the hospital visits? The visits did not go out with any modifiers. I feel like it needed mods since patient received chemo, which would prompt the above denial. Same denial we get if a regular E&M goes out without a mod 25 and injection/infusion done same day.
2. Are these visits considered a part of the global surgical package (because the biopsy came back malignant which is the reason for the chemo) or is it separate since the visits relates to the chemo and not the surgical procedure itself, and it is a separate MD/subspecialty seeing the patient in regards to the chemo.
I over all feel like these visits need mods, but am unsure if it needs only a 25, a 24 and a 25 or a combination of mods im missing all together or if these are just all inclusive to the global period and we have to write off.
Your help is much appreciated.