coffee2day
Networker
Hello,
If a patient develops post op infection during the global period, say pacemaker infection and returns to the OR, is it correct that we cannot bill the e&m hospital visits with modifier 24 still? I am getting mixed advice.
From reading the medicare guide, it reads to me that only the return procedure can be billed, and that "it does not include a patient's room". Which makes me think we cannot bill the e&m hospital visit with modifier 24 for a complication, is this correct? Some say that we can bill an e&m in an hospital or office visit in the global with a complication diagnosis if a decision to return to OR was made, but I can't find resources supporting this. Any advice would be greatly appreciated, thank you!
"Treatment for post-operative complications requiring a return trip to the Operating Room (OR). An OR, for this purpose, is defined as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient’s room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient’s condition was so critical there would be insufficient time for transportation to an OR);
If a patient develops post op infection during the global period, say pacemaker infection and returns to the OR, is it correct that we cannot bill the e&m hospital visits with modifier 24 still? I am getting mixed advice.
From reading the medicare guide, it reads to me that only the return procedure can be billed, and that "it does not include a patient's room". Which makes me think we cannot bill the e&m hospital visit with modifier 24 for a complication, is this correct? Some say that we can bill an e&m in an hospital or office visit in the global with a complication diagnosis if a decision to return to OR was made, but I can't find resources supporting this. Any advice would be greatly appreciated, thank you!
"Treatment for post-operative complications requiring a return trip to the Operating Room (OR). An OR, for this purpose, is defined as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient’s room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient’s condition was so critical there would be insufficient time for transportation to an OR);