Bone Up On ASC Orthopedic Coding With These Global Period, Modifier Tips
Posted on 29. May, 2009 by Editor in Hot Coding Topics
3 ways your physician claim better look different than a center claim.
Think the same post-op and incomplete procedure modifiers apply regardless of whether you’re coding for an ambulatory surgery center (ASC) or a physician? Save your claim from disaster by focusing on these variations.
Change Postoperative Surgery Coding After Day 1
Every procedure billed by the ASC has a “same-day” global period, which makes sense because the ASC is not reporting physician work services — only facility fees. This applies to the coder working for the ASC, but not the physician who performed the service, says Catherine Bowie, CPC, surgical and ASC coder for Central Maine Orthopaedics, PA in Auburn.
Before you read on, can you answer THIS orthopedic coding stumper? How do you code when a joint replacement needs a replacement. Don’t miss our joint replacement AUDIO on May 27.
Example: A patient experiences postoperative bleeding and the physician must return the patient to the ASC for control of bleeding on the same day. Both the physician’s coder and the ASC’s coder should report the appropriate control-of-bleeding code appended with modifier 78 (Unplanned return to the operating /procedure room by the same physician …) because the procedure occurred within the ASC’s “same-day” global period.
Red flag: For postoperative operations beyond day 1, realize who you code for makes a difference in your modifier coding. The ASC coder should follow the “same-day” global rule, but the physician’s coder should follow standard global period rules from the fee schedule, says Annette Grady, COSC, CPC-H, CPC-P, CCS-P, PCS, FCS, senior orthopedic coder and compliance auditor for The Coding Network.
Example: Suppose in the above example the physician returned the patient to the ASC the day after the initial...
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