Tuesday, January 10, 2012

Surgical Global Periods

I am confident that all doctors have at least a basic understanding of the global package and what is expected of them during that time. However, what does and does not fall under the global period continues to be an issue for providers and medical billers alike.

Scenario #1: Provider performs pre-op visit and the subsequent surgery. Upon the follow -up visit, everything is found to be normal.

  • Since the provider has already been reimbursed for the entire global period, there is no additional reimbursement. The provider should bill a 99024 to create a permanent record that the patient was seen for post-op evaluation.

Scenario #2: Provider performs pre-op visit and the subsequent surgery. Upon the follow-up visit, Provider finds a postoperative infection that needs additional care.
           
  • The infection is unrelated to the diagnosis for which the surgical procedure was performed, therefore the provider should receive reimbursement for this encounter. The provider should code the encounter as they normally would for an office visit, but they must include a 24 modifier. Without the 24 modifier, the claim will be denied. 

A doctor can avoid a lot of denied claims by making sure that the biller includes the 24 modifier with claims such as in Scenario #2. If the modifier is not included, the claim will be denied and the biller will be left to try to figure out what caused the denial. The claim must then be appealed, where they will likely request chart notes. This requires an extensive amount of time and labor before the provider will receive reimbursement.

A good line of communication can avoid most of these denials on the front end.

Medical Billing Services & Solutions

5 comments:

  1. Nice article. Thanks for sharing this information. It's a good addition to my reference.

    ReplyDelete
  2. Hi,

    What an idea that you have shared to us, its really superb. Good Medical Billing Collection procedures are critical to maintaining cash flow in your practice.

    ReplyDelete
  3. So that's what I was trying to figure out these days. This blog is very helpful to me. Thank you for your valuable time and this information !!

    Also Visit : http://acerhealth.com/

    ReplyDelete
  4. one year ago was really a tough year for me,my wife and my family . I have never been the type to believe in online platforms to make money, I have always believed in rendering services and adding apparent values to anything and then making money from it. But when COVID struck,my business had to shut down,then I was left with no choice but to think of other legit ways to make money . I was presented a lucrative offer in ‘FX INVEST OPTION’ since it was the only thing that was making sense as at the time I wanted to invest. All thanks to = GLOBALFXINVESTMENT2@GMAIL.COM, I cannot thank them enough,one of my business associates referred me to them when he heard of my situation after reaching out to loan some money from him ,I contacted them via their email,and related necessary information and requirements as requested by the specialist who asked for all the necessary details and in less than a week ,they were able to retrieve all I lost to this fake investors,It seemed like a dream to me because I had lost all hope. I told them I will tell the whole world about what they did for me,they literally restored me to life. If you’re seeking funds/Cryptocurrency from online scammers , contact them rightly away;- at GLOBALFXINVESTMENT2@GMAIL.COM and also his Telegram @FX_INVEST_OPTION
    Also contact him +1 (505) 317-3340…

    ReplyDelete