Wiki Audit-Surgery Guidelines/Surgical Package

[tboback]

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]

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.