Results 1 to 5 of 5

Thread: 20610

  1. #1
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Red face 20610

    I'm feeling quite dumb today. Would it be appropriate to code 20610 during a global period for the same knee? The patient is still having pain and yes, she is Medicare. Can I code 20610-79
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Join Date
    Apr 2007
    Location
    ENGLEWOOD/DENVER
    Posts
    2,339

    Default

    ONLY because the patient is Medicare, you will be unable to capture for the injection/aspiration, this is considered part of the global surgical package for Medicare. The only way to capture anything like that post operatively is to take the patient back to the operating room.

    This is for MEDICARE patients only. This directive is regarding the 24 modifier, but see the example that is highlighted.

    Medicare B News Issue 180 Mar 2000
    Publish Date March 2000
    States Affected AK,AZ,CO,HI,IA,NV,ND,OR,SD,WA,WY
    Subject MODIFIER 24 - Appropriate Use
    "Medicare reimburses surgical procedures under a Global Fee Methodology. According to HCFA guidelines, payment is allocated on a percentage basis for preoperative, intraoperative and postoperative care.

    Based on a complex medical review of claims during October through December, 1999, this carrier has identified that some providers incorrectly use MODIFIER 24, which indicates an unrelated E/M service by the same physician during the postoperative period.

    Postoperative care includes all related E/M services rendered from the day of the surgery through the end of the indicated global period, as established in the Medicare Physician Fee Schedule. Any routine followup, consisting of an office visit, a surgical procedure performed in the office due to postoperative complications, or admission and follow up E/M in the hospital, should not be billed as a separate service. These services are considered to be included in and part of the global service period of the surgical procedure.

    Examples:
    Status post knee surgery: The patient returns with increased pain and swelling. Physician performs an ARTHROCENtesis. Both the E/M visit and procedure code 20610 are included in the postoperative fee.


    Patient is status post mastectomy: The patient returns to the office after a fall at home, with bruises on arms and legs. An E/M service with a MODIFIER 24 is justified as a separate, non-surgery-related visit."
    Last edited by mbort; 01-15-2009 at 02:21 PM.

  3. #3

    Default

    I thought you could bill 20610-58, for related procedure or service during the postop period.
    Daisy

  4. #4
    Join Date
    Apr 2007
    Location
    ENGLEWOOD/DENVER
    Posts
    2,339

    Default

    not for Medicare..other payors..yes

  5. #5
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Cool

    Thanks Mary - I was pretty sure you would come through with an answer for me!

    I don't know why I was drawing a blank today.
    Thanks again!
    Lisa Bledsoe, CPC, CPMA

Similar Threads

  1. 20610
    By svms in forum Orthopaedics
    Replies: 1
    Last Post: 08-14-2014, 05:01 PM
  2. 20610
    By svms in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 08-13-2014, 10:47 AM
  3. 20610
    By darlene.dean@lpnt.net in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 09-01-2010, 08:22 AM
  4. 20610
    By jordan135 in forum Orthopaedics
    Replies: 1
    Last Post: 01-28-2010, 04:28 PM
  5. 20610
    By samorn in forum Orthopaedics
    Replies: 4
    Last Post: 11-12-2009, 01:50 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •