Can wound care be billed after patient is discharged but returns within global?

dncooke03

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]Hello to all!

Here's the scenario:

A patient had surgery on March 13, 2018 for a partial toe amputation (CPT 28124). Of course, he received post-operative care during the next 4 weeks. He was considered healed and discharged on April 17. (Remember, he's still in his global period). HOWEVER, the next day, April 18, the patient called the office stating his incision site had started bleeding again even after the doctor declared him fully healed. No injury to the toe per the patient. He came back in today, April 19 and the doctor performed wound care.

My question is...Since, it was documented on April 17 that the patient was HEALED and DISCHARGED, are we allow to bill for wound care with the applicable modifier since a NEW problem arose? Or is it still considered part of the original global period, thus making it continued post-operative care? I think it's the latter but wanted clarification. Of course, the doctor is wanting to bill separately.

Thanks in advance for any help!
 

jdibble

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Best answers
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]Hello to all!

Here's the scenario:

A patient had surgery on March 13, 2018 for a partial toe amputation (CPT 28124). Of course, he received post-operative care during the next 4 weeks. He was considered healed and discharged on April 17. (Remember, he's still in his global period). HOWEVER, the next day, April 18, the patient called the office stating his incision site had started bleeding again even after the doctor declared him fully healed. No injury to the toe per the patient. He came back in today, April 19 and the doctor performed wound care.

My question is...Since, it was documented on April 17 that the patient was HEALED and DISCHARGED, are we allow to bill for wound care with the applicable modifier since a NEW problem arose? Or is it still considered part of the original global period, thus making it continued post-operative care? I think it's the latter but wanted clarification. Of course, the doctor is wanting to bill separately.

Thanks in advance for any help!
90 days is the global for the procedure. If this is related to the amputation - which it sounds like it is, then it would not matter if the doctor declared the toe healed. Apparently it was not as healed as he thought! :rolleyes:
 
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