Neurosurgery Coding Alert

Question: A patient undergoes a parietal craniotomy to excise a brain tumor. Several weeks after surgery, signs of infection appear, including redness and pus at the suture line. The neurosurgeon performed an E/M to prescribe antibiotics. Should this be part of the global period? Also, the neurosurgeon took the patient back to the OR to perform debridement. What should my claim entail? Georgia Subscriber Answer: If this is a non-Medicare patient, depending on the payers rules, you may be able to report E/M services (such as 99213, Office or other outpatient visit for the evaluation and management of an established patient &) with modifier 24 (Unrelated evaluation and management service by the same physician during a  postoperative period) appended. Because the surgeon must determine what antibiotics are warranted, which type, and how long they should be given, you may consider these E/M services as separate from the typical postoperative global [...]