Audit-Surgery Guidelines/Surgical Package

tboback

Networker
Messages
43
Best answers
0
We have a doctor who performed a surgery with no internal fixation (90 day global).

Day 13 he billed E/M (denied) with x-ray (paid)
Day 50 he billed E/M (denied) with x-ray (paid)

We expect to see more E/M and x-ray services within the 90 day global from this doctor for the same patient.

This doctor has a tendency to over utilize/abuse his services for auto/WC. Is his billing practices within the guidelines?

Any information/websites that have more detailed guidelines would be appreciated.
Sincerely,
Tina M Boback CPC
 

mitchellde

True Blue
Messages
13,429
Location
Columbia, MO
Best answers
1
instead of the E&M code you should 99024 for post op visit this is a 0 paid but it correctly captured=s the encounter.
 
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