Wiki postop or office visit?

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wynonna

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MD did a drainage of abscess--30020. Less than 10 days later patient came in and was given the results of the fluid previously drained from same abscess by our MD.
The culture results showed as MRSA. The PA treated it by prescribing a new RX and billed 99214. She is from the same office as MD who did drainage of abscess.
Is this correct since MRSA is a new dx? Or postop only and non-billable?
thank you fellow coders
 
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I'd consider it a new problem with a new plan of care and bill an appropriate E/M. However, I'm curious about what others think about your scenario and look forward to reading other responses.

Edited to add some pertinent words I left out.
 
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I would also consider this billable outside of global. From the Medicare global surgery booklet:
"Treatment for the underlying condition or an added course of treatment which is not part of normal recovery from surgery" is not included in global.
Not sure it meets 99214, but is a billable visit.
 
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wynonna said:
MD did a drainage of abscess--30020. Less than 10 days later patient came in and was given the results of the fluid previously drained from same abscess by our MD.
The culture results showed as MRSA. The PA treated it by prescribing a new RX and billed 99214. She is from the same office as MD who did drainage of abscess.
Is this correct since MRSA is a new dx? Or postop only and non-billable?
thank you fellow coders
Click to expand...
A couple of thought to consider, post-op guidelines, y. Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician. 2. The Medicare Global billing has guidelines and examples that might apply to your type of visit. https://www.cms.gov/outreach-and-ed...oducts/downloads/globallsurgery-icn907166.pdf Non Medicare follow your CPT, AMA guidelines for follow up in a post-op period, as for dx they are different so that is fine, if you are following 2021 MDM guidelines or time depends on the E/M level choice.

Hope that helps.
 
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