post partum complication

lroldan

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We have a pt. that delivered 6wks ago and now has an infection at the site of her episotomy. I'm not sure if I can bill this as an office visit with a dx of infection w/modifer 79 or should this visit be part of the global package? The pt is due to come back next week for another visit due to her infection.

Any suggestions?

Thank you.
 
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Post Partum

This would be global you would actually have to provide documentation in the medical record to support that the procedure or visit were "unrelated" to the birth. If it were provable then modifier 24 would be appropriate. Modifier 78 is correct in this situation.
Hope this helps
Kathryn CPC-A FWB Florida
 
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We have a pt. that delivered 6wks ago and now has an infection at the site of her episotomy. I'm not sure if I can bill this as an office visit with a dx of infection w/modifer 79 or should this visit be part of the global package? The pt is due to come back next week for another visit due to her infection.

Any suggestions?

Thank you.
Hi,
Beyond 6 weeks is not global period.
Can code office visits-Dx-674.3
 

triplejok

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You can bill for it w/ a modifier -24 added to indicate an E/m srevice is unrelated to typical postpartum care during global period.
 
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78 was wrong

I'm sorry I was thinking operatively but the procedure is still global at 6 weeks. I believe as long as the intial complaint is within the 6 weeks you cannot charge separately though.
 

lroldan

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Thank you....I was not thinking about E/M for modifier I was thinking of the delivery. I appreciate you advise.
 
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Suzanne H, CPC SLC, UT

If the patient came in even during her global post partum period - 6 wks for vag and 8 wks for Csection.....it is most definitely billable as long as the documentation supports the extra work the physician provided. Wound dehiscense and wound infection are not routine care and are billable with the appropriate E/M or I&D or wounding packing codes. Modifier 24 is the correct one to use in this situation.
Sometimes you may need to submit the documentation, but it is appropriate in those circumstances
 
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