Aftercare (suture removal, dressings, etc.)

pinnaclephyserv

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Should I just bill E/M code for aftercare sx that was performed by another physician in another state?

Thanks in advance for any help.,
 

CodingKing

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If its still in the global period and there was a transfer of care for the post-op portion then you would report the original surgical procedure with modifier 55 for Postoperative Management Only.
The other provider should be reporting the procedure 56 & 59 for pre-op and inter-op. Though typically the surgeon fails to code the modifier showing the transfer of care, so you will probably need to contact original surgeon to correct their claim when yours rejects.
 

pinnaclephyserv

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There was no transfer of care. The patient was in another state and was injured, so he's home to have post op care. I am pretty sure the surgeon did not bill with modifier 54.
Thanks
 

CodingKing

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Surgical treatment where injury occurred and follow-up at home is the definition of transfer of care. You will need to work with the primary surgeon to make sure they did not report the full global package . If it was as simple as just removal of suture then it could be billed under a nurse visit 99211.
 
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