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32208 global period with 93650

Date: Jan 8, 2018

Question:

When our doctors perform an AV node ablation (93650) with pacemaker implant (33208) on the same date, we have been getting denials for code 93650. Specifically because code 93650 was billed in the global period for code 33208. I believe this may be payer specific. Should I append a modifier -78/-79, or should I appeal to the payer?

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