aaron.lucas
Expert
Hello all,
We're kinda going back and forth on this, not sure what the specific guidelines are, if any for this situation. The provider performed an ORIF on a radial shaft fracture (25515). Now, during the global period, they are billing for x-rays of the forearm (same forearm). Upon reading the Surgery Section guidelines, we saw that under "Follow-Up Care for Therapeutic Surgical Procedures" it says follow-up care includes care which is usually part of the surgical service. So our question is, because the procedure performed is an ORIF, and the x-rays are on the same location as the surgery, would that be considered "usually part of the surgical service", since the only way to check up on the healing progress would be through an x-ray right? Or are we reading between the lines to much? Any insight or reference to guidelines, CMS, AMA or otherwise will be greatly appreciated!
Thanks,
We're kinda going back and forth on this, not sure what the specific guidelines are, if any for this situation. The provider performed an ORIF on a radial shaft fracture (25515). Now, during the global period, they are billing for x-rays of the forearm (same forearm). Upon reading the Surgery Section guidelines, we saw that under "Follow-Up Care for Therapeutic Surgical Procedures" it says follow-up care includes care which is usually part of the surgical service. So our question is, because the procedure performed is an ORIF, and the x-rays are on the same location as the surgery, would that be considered "usually part of the surgical service", since the only way to check up on the healing progress would be through an x-ray right? Or are we reading between the lines to much? Any insight or reference to guidelines, CMS, AMA or otherwise will be greatly appreciated!
Thanks,