Orthopedic Coding Alert

Question: A patient who was four weeks post-operative for a fasciotomy of the right elbow (24351) reported for follow-up. We did an in-office incision and drainage (I&D) of his wound. Is this a postoperative complication included in global, or can I charge for it?

California Subscriber

Answer: Because the infection (998.51, infected postoperative seroma) is related to the original surgery, reimbursement will depend on the carriers policy for treatment of postoperative complications. If the patient is a Medicare beneficiary, the I&D is considered part of the global surgery package because procedures performed due to postoperative complications are covered only when they require a return to the operating room. Commercial carriers guidelines differ, so ask your carrier if the service is eligible for reimbursement. If it is, ask which modifier should be appended to the I&D code, 10140 (incision and drainage of hematoma, seroma or fluid collection).