Otolaryngology Coding Alert

Check out these three examples to test what you've learned.If you include postsurgical infection care in your primary procedure's global surgical package every time, stop. You could be missing out on legitimate revenue. To determine whether you deserve additional reimbursement, follow these two tips.Tip 1: Distinguish Between Medicare and Non-Medicare PatientsMedicare treats postoperative complications, including infections, differently than insurers who follow CPT® guidelines. Although both CMS (Medicare) and CPT® guidelines indicate that the global surgical package includes "typical" postsurgical care, the two sources differ regarding what qualifies as typical -- which means you must differentiate your claims depending on which payer you are coding for.Medicare requires that a complication be significant enough to warrant a return to the operating room before you may report a separate procedure in the global period. In fact, CMS "Correct Coding" guidelines specifically state, "When the services described by CPT® codes as complications of a [...]