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You Be the Coder: Urinary Retention by James Smith
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You Be the Coder: Urinary Retention |
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Health
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Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Can you bill for urinary retention after prostate seed implantation during the global period? I say put a modifier -79 on the catheterization or a -24 on the evaluation and management visit. Does an intraoperative consult automatically become a level four or five (i.e., to find a ureter for a general surgeon)?
-Florida Subscriber
Answer: Per CPT guidelines, postoperative urinary retention would be reported separately because it could not be considered normal uncomplicated follow-up care. Modifiers -24 (unrelated E/M service by the same physician during a postoperative period) and -79 (unrelated procedure or service by the same physician during the postoperative period) would be correct.
There are some payers, however, who would consider the retention a complication of the procedure and not allow payment for services provided in the physicians office. Check with the payer for specific guidelines. Most payers should consider office services for post-op retention exempt from the global period of the surgery because the retention was not due to a problem with the surgical technique. Medicare and private payers have been known to deny the services even with correct modifier usage, so you may have to appeal For Read full article You Be the Coder: Urinary Retention
Related Articles -
CPT guidelines, CPT, CPT Coding,
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