Wiki procedure during Observation Care

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avrilw

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We have a patient who was admitted to Observation care on 8/2/11. They had a procedure with a global period on the same day. The procedure (46040) and Initial Observation (99219) were paid but the Subsequent Observation (99225) on 8/3/11 as well as the Observation Discharge (99217) on 8/4/11 were denied as part of the global. Can we bill the 99225 and 99217 after a procedure and expect pay or should we not be billing for those?
 
Global

All E/M services performed during the global period are included in the reimbursement for the procedure, UNLESS totally unrelated to the procedure.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
what if the procedure is a stent placement that has a zero-day global? Can you then bill for the subsequent day after the procedure (stent placement)? If so should you use the 99217 since they are being DC'd?
 
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