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POST-OP BILLING QUESTION

Ellen Posted Thu 06th of February, 2014 16:07:49 PM

I am attempting to bill post-op charges 11603-79 and 12032-59-51 on the same claim. Should modifier 79 be included on the 2nd line charge? ex:12032-79-59-51. Please assist. I am a bit confused.
Thanks Arlene

SuperCoder Answered Fri 07th of February, 2014 09:39:36 AM

You append modifier 79 on CPT Code 11603.

Again Note: Check with all of your private payers to familiarize yourself with their specific rules and guidelines regarding global surgical package reimbursement because these vary from payer to payer.

Services included in the global surgical package include pre-, intra-, and post-surgical and medical care, supplies, and any miscellaneous services. Services not included in the global surgical package may include the initial consultation or unrelated evaluation and management (E/M) service.

Note: Medicare will not allow reimbursement for post-operative services that are related to the recovery from a procedure when performed within the global period.

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