Wiki postpartum infection

[rleif1sun]

if patient returns 6 days post vaginal delivery for infected episiotomy site for which antibiotic was prescribed, is considered part of global package or can bill separately with e/m and modifier 24?

 

[csperoni]

Using CMS guidelines for global surgery, this would be included as it is a complication that did not require a return to the OR.

 

[nielynco]

Using CMS guidelines for global surgery, this would be included as it is a complication that did not require a return to the OR.

But per CPT guidelines, this would be a codeable visit as it was for a complication of delivery.

 

[csperoni]

But per CPT guidelines, this would be a codeable visit as it was for a complication of delivery.

Yes, this is one of those issues where CMS and AMA guidelines do differ. I should have mentioned that, and have in the past. For my employer, we are instructed to use CMS guidelines as our insurance contracts specify CMS guidelines. If your provider contract permits, it could be billable.