Wiki Can you bill an office visit for infection after sx.

[jbreen]

My Dr. did a procedure 19020 (incision breast lesion) and then six days later (3 post op visits later) the doctor saw the patient with dx V09.0 (infections with microorganisms resistant. Can he bill an office visit?

 

[mbort]

yes with a 24 modifier, if the reason for the visit is now for infection.

 

[jharrell]

I don't see how you can bill an e/m with a -24. Because a -24 is for unrelated e/m during the post-op period. So how can it be unrelated if the pt would have not got the infection unless they had the surgery? Can anyone direct me to where I can find that you put a -24 on it. I know in the CPT guidlines it says you can report it separately, but it says nthing about what modifier to use.

Thanks,
Jessica Harrell, CPC

 

[relong]

If its within the global period and related to the surgery you shouldn't bill it.

 

[emeskina]

Yes, you can!

The CPT surgery guidelines state the following:

Follow-up care for therapeutic surgical procedure includes only that care which is usually part of the surgical service. Complications, exacerbations, resurrence, or the presence of other diseases or injuries requiring additional services should be seperately reportable.

BUT, if the carrier is Medicare, you cannot bill for the E/M.

 

[jharrell]

I know it says that! But where does it say that you use a -24. Because -24 is an unrelated mod I have a had time using it.

Jessica Harrell, CPC