Susan Posted Fri 24th of February, 2017 13:39:46 PM
On initial OB exam doctor discovered large abdominal mass. Sent for stat ultrasound, patient with 23 cm abdominal mass. she will need perinatology consult to determine if needs general surgeon or gyn oncology. Can this visit be billed outside of global package. Will it need a modifier 25? Should the entire visit be counted toward the LOS or just the parts relating to the mass and mot the pregnancy? I know the minute they see a pregnancy dx insurance includes in global.
SuperCoder Answered Mon 27th of February, 2017 01:30:18 AM
The abdominal mass finding and additional work-up is not the part of routine OB exam, so you can bill this visit outside the Global package with modifier -25.