Wiki Post op infection billable or global?

[Vanessa123]

Hello everyone,

I am having a bit of a memory loss. If patient comes back to the office for a post op visit after a total abdominal hysterectomy or a c-section and the site of surgery has now become infected. Can you bill an office visit for the complication of the infection during the post op period or is that considered part of the global package.

Thanks in advance.

Vanessa

 

[LTibbetts]

This is what I was taught:

NO E/M services related to the surgery can be billed to Medicare in the post-op global period. Many commercial carriers are starting to follow CMS lead on this. But per CPT infection is NOT routine post-op care, so some commercial carriers are still paying with the -24 modifier.

So I guess it depends not only on the carriers but also if the pt has to go back to the operating room. If that is the case, I believe you can code it but only with the appropriate modifier.