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Inpt - Rehab question

Denise Posted Fri 26th of October, 2012 13:18:12 PM

A patient is admitted and has surgery under one physician... then
our provider, who manages the patients rehab services, is called in
for the initial consultation (while in-house, before going into the
rehab unit)... we are experiencing rejections stating inclusive in
w/global (surgery) code - what modifier do we use to identify this
as another provider evaluating the patient for rehab?

SuperCoder Answered Mon 29th of October, 2012 14:27:25 PM

Hi Denise,

We are working on this. Will get back soon.

Thanks

SuperCoder Answered Thu 31st of January, 2013 21:07:01 PM

Denise,

This question was escaped from our database and we apologize for the delay in answering.

The only EM modifier for getting past a global package block is modifier 24 ‘Unrelated* E/M service by the same physician during a post-op period’ but this is for a different physician. I'm assuming they must be billing under the same tax id and that is why it is getting blocked.Sounds like a call to the payer is in order and if they push back then start an appeal.

Thanks for being patient for such a long time.

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