Billing > Billing

medicare billable CPT, bundle codes

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MBP:
i've read so many posts on this forum over the last few days that now although i do remember reading about combinations of codes and bundles somewhere - cant find it  >:( could someone please tell me where can i find groups of cpt codes that are billable/are not? i tried medicare website, but again, no luck.. case of mondays for me!! ;D e.g. medicare always rejects 99238 for the surgeon i bill for. when she discharges a patient from the hospital, that is never paid for... being new.. - i can't find a modifier i would use as this is not a procedure, but a visit.. so i thought it could be a part of bundled code?

PMRNC:
Wouldn't the discharge date be a part of the global surgical period?

Michele:
We would have to know the reason that the 99238 is being denied.  Like Linda said, it may be part of the global period, or is it possible another physician billed for the discharge first??

Michele

MBP:
i agree it should be, but in some cases (e.g. 19307 or 44950 - global 90 days) some insurances (e.g. health alliance plan) do pay for 99232 (consults after the sx while still in the hospital) and for 99238 (discharge).. i have noticed that the previous biller was using mod 24 in some cases to get paid for 99238.. i dont know if that is correct..  :-\

edypowers:
You can not bill for the discharge.  It is included no matter how many global days in the global period. If it is a 0 day global period then it is most likely and out patient.

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