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Posted By Christie on 10-19-2005, 20:08:00 in Radiology
Hello List,

Scenario: 1st thrombectomy 7/1/05
2nd thrombectomy 8/2/05 used modifier 79
3rd procedure 09/30/05 36556-79, 75998
Now my question is: Does the 90 global days start each time the modifier 79 is used or does 7/1/05 stay as the initial global date until 10/1/05?

Thank you so much
Comments (11)
Posted By tess on 10-24-2005, 12:34:00
I don't have a reference either, but I, too, believe that the global period starts over again.

T.
Teresa Halliday, CCS-P
Coding and Compliance Coordinator
Radiology Associates
thalliday@ranh.net
315-793-8806/phone
Please visit us at: http://www.yourradiologist.com
Posted By STACIE on 10-23-2005, 15:15:00
Thanks! I don't know how the heck I missed that one.

Stacie L. Buck, RHIA, LHRM
Vice-President

Southeast Radiology Management
"Your Radiology Business Experts"

Specializing in:
-Billing & Collections
-Consulting
-Practice Management

Phone (772) 600-0324 Fax (772) 600-0327
Posted By Donna on 10-23-2005, 01:18:00
Medicare Claims Processing Manual, Chapter 12, Sect 40.2.6 and 7
(this is the end of .6 and the beginning of .7 - staged procedure modifier and unrelated procedure modifier:
circumstances may be reported by adding modifier “-58” to the staged procedure. A new postoperative period begins when the next procedure in the series is billed.
7. Unrelated Procedures or Visits During the Postoperative Period
Two CPT modifiers were established to simplify billing for visits and other procedures which are furnished during the postoperative period of a surgical procedure, but which are not included in the payment for the surgical procedure.
Modifier “-79”: Reports an unrelated procedure by the same physician during a postoperative period. The physician may need to indicate that the performance of a procedure or service during a postoperative period was unrelated to the original procedure.
A new postoperative period begins when the unrelated procedure is billed.

>
Posted By STACIE on 10-22-2005, 12:17:00
Really? I hope you find it. :-)

Stacie L. Buck, RHIA, LHRM
Vice-President

Southeast Radiology Management
"Your Radiology Business Experts"

Specializing in:
-Billing & Collections
-Consulting
-Practice Management

Phone (772) 600-0324 Fax (772) 600-0327
Posted By Donna on 10-21-2005, 19:58:00
I've been looking for my reference for this - but I'm pretty sure that the
global period re-starts when you use modifier 79.

Donna J Richmond, CPC, RCC
CodeRyte, Inc.
337-236-3755 phone/fax
337-412-2272 cell/voice mail
email: drichmond@coderyte.com
email: djr1215@cox.net
Posted By STACIE on 10-21-2005, 18:11:00
The global period would not start over in the original scenario you
presented.

Stacie L. Buck, RHIA, LHRM
Vice-President

Southeast Radiology Management
"Your Radiology Business Experts"

Specializing in:
-Billing & Collections
-Consulting
-Practice Management

Phone (772) 600-0324 Fax (772) 600-0327
Posted By Christie on 10-21-2005, 15:22:00
Hey Stacie,

Actually, this could be modifier 78, however, I like Walt Blackman's
take on it to use 79. So, is there only one 90 day global with
thrombectomy 36870 or does it start over each time another 36870 occurs(I think not, but need others opinion, such as yourself.) Thanks again
Posted By STACIE on 10-21-2005, 12:10:00
I had asked to make sure it couldn't have been a -78.
Posted By Donna on 10-21-2005, 01:54:00
Some people use -79 saying that if the graft clots again - it's not a
complication of the previous clotting/declotting - it's an entirely new
process - unrelated.

Others say use -78 - because they consider it a complication of the graft
disease process.



Donna J Richmond, CPC, RCC

CodeRyte, Inc.

337-236-3755 phone/fax

337-412-2272 cell/voice mail

email: drichmond@coderyte.com

email: djr1215@cox.net
Posted By Christie on 10-20-2005, 19:56:00
Hello Stacie,

Thanks for helping me. Well, I have been to a few of Walt Black's
seminars and when it comes to the dialysis AV shunts which clot often,
per Walt, he explained to use modifier 79 as opposed to 78. So, with
that information, were you going to add more to the 90 day determined
date? Again, thanks a lot.
Posted By STACIE on 10-20-2005, 01:53:00
-79 Unrelated Procedure or Service by the Same Physician During the
Postoperative Period: The physician may need to indicate that the
performance of a procedure or service during the postoperative period was
unrelated to the original procedure.

It is my understanding the "original" procedure in the scenario below is the
first procedure done on 7/1/05 and that determines the 90 day period.

Were the subsequent procedures truly unrelated to justify -79?


Stacie L. Buck, RHIA, LHRM
Vice-President

Southeast Radiology Management
"Your Radiology Business Experts"

Specializing in:
-Billing & Collections
-Consulting
-Practice Management

Phone (772) 600-0324 Fax (772) 600-0327
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