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Intraoperative Monitoring - Bill Global or Seperate the Components

Connie Posted Fri 29th of October, 2010 16:05:05 PM

One of my clients provides intraoperative monitoring during surgery. She was told by a colleague that she should be billing the claims globally with a pos 21.

My research shows that these codes (ex:95920, 95861, 95926, 95927, 95904)can be billed globally or with a technical and professional modifier. But which way of billing these codes is correct. How do I know if we should bill globally or break the components apart?

The other question is the place of service. The colleague states she bills with POS-15 or 21. Is this right?

From what I can tell these codes should be seperated with the pos-11 and mod-26 on the professional and pos-21 and mod-TC on the technical. Is this right or should I just be billing globally?

SuperCoder Answered Mon 01st of November, 2010 20:47:20 PM

15 is for a mobile center. These are diagnostic; if this is intaoperative monitoring for surgery, it should be 21. IM global vs component monitoring depends on 1) who's employee the monitorer is; 2) who owns the monitoring equipment. In ENT surgeries, a private practice employed audiologist with her own equiment may provide the monitoring in a facility and she would bill the global; so just becuase monitoring is performed in the hospital (21) does not mean the hospital owns the equipment and automatically bills 21. Instead, use TC for whoever owns the equipment, 26 for whoever provides the monitoring -- and the global if both entities are the same.

Jen Godreau, CPC, CPMA, CPEDC
Content Director, SuperCoder.com

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