Wiki Post-op versus subsequent visit

[maine4me]

I bill for a general surgery group and there recently has been some question as to what complications would warrant a subsequent visit as opposed to a post-op visit. I have provided the practictioners with the guidelines but still they have questions. Please review the following clinical scenario.

Patient comes in for a laparoscopic cholesystecotomy. After being released to the med/surg floor the patient develops a bile leak, which ultimately requires stent placement by the GI group.

The question is would surgical visits following the bile leak be considered post-op or can they be billed as a subsequent visit? My gut feeling this is post-op since a bile leak is probably a common complication of a lap choly.

Please help.

 

[colorectal surgeon]

certainly this is a post-op visit.

As a surgeon, I could count on two hands the number of patients per year that I see in the global period who aren't there for something related to their procedure (i.e. a 24 modifier is used on the E&M)

 

[maine4me]

Follow up question

If a patient is in the hospital for an extensive stay that requires 3 surgeries, how would I know if subsequent visit would be billable? All three surgeries have 90 days post op period, so my first thought is no, but am unsure with this very complex case. The length of stay is from 7/30/13 through 10/9/13 in the acute care portion of the hospital, and beginning on 10/9/13 he is in rehab. What would I look for to warrant billing for subsequent visits during this time?