ED Coding and Reimbursement Alert

Question: A doctor in our emergency department removed nasal packs that a different doctor had inserted. The physicians belong to the same ED group. Is there a code for the nasal pack removal? It's not a foreign body, so I am unsure. I think the removal is part of the initial service, if the same doctor put in the nasal packing. How about if it is a different doctor?

Codify Subscriber

Answer: If the packing was placed and removed by the same ED group, then the second service would likely fall into the construct of typical postoperative care. Keep in mind that depending on the initial procedure (such as treatment for epistaxis) there could be a zero-day global period. So check your initial service and make sure you are outside of the global period and it is not part of typical care.

If you are outside of the global period, an E/M code is usually the best way to report the follow-up service that the second physician provided.