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Post-operative wound care

  1. Default Post-operative wound care
    Medical Coding Books
    We have a physician who recently started seeing patients at a Wound Care Center. We are questioning whether we can bill for this or not. The majority of these patients are in their post-op 90 day global period and are coming to the wound center for dressing changes. He wants to bill an e/m visit.

    Has anyone dealt with this situation before? Any resources that you could share?

    I'm looking everywhere, but all I find is in regards to wound treatment. Sometimes he performs debridement, but he never performs treatment that require cpt codes 95797-97610.

    Any help would be appreciated.


  2. #2
    I have from CMS a manuel called Surgery and in it there is, first the definition of the Global Surgical package and that states; A global package of care consist of all necessary services performed by the physician BEFORE, DURING and AFTER a surgical procedure. It also goes on to outline what services ARE and ARE NOT included in the Global Surgical Package and under the INCLUDED it states Items such as Dressing changes, local incision care and removal of operative pack..ect. so I would say that these services are included in the procedure he already performed.

  3. Default
    Thanks. I have that as well and am waiting to discuss this situation with my manager.

  4. Default
    Is your provider the one who did the surgery for which the patient is needing a dressing change, or did someone else do the surgery?

    I would say if your provider is treating patients that had a procedure by another provider, your provider could bill E/M. The global period only applies to the provider (or provider group) doing the procedure. You could add modifier 55 (post-operative management only) to indicate your provider is separate from the provider that did the procedure or surgery.

  5. Default
    In most of the cases he is the provider that performed the surgery, but he has a fellowship in wound care and feels he should be able to bill for this service inside the global period.

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