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I&D under global care

  1. Default I&D under global care
    Exam Training Packages
    I had a patient come in on 10-1-09 and had a abscess on face I&D 10060. Patient is back in the clinic for a follow up on 10-5-09, but a different sees a different provider same clinic though. This provider ends up opening up the abscess again and expressing puss and packs it. Would this full under global care or can I code 10060 with a modifier?


  2. #2
    Yes you can charge it again, but I would use 10061 since he packed it. And put mod 78 on it.

    Jessica Harrell, CPC

  3. #3
    North Carolina
    For Medicare purposes, 78 requires a return to the operating room for a related procedure during a postoperative period....Included in global surgery= "All additional medical or surgical services required of the surgeon during the postoperative period of the surgery because of complications which do not require additional trips to the operating room".

    One could argue that this would be considered a more extensive procedure...Modifier 58. If the carrier follows CPT's definition of global surgery, it could be paid...

    CPT's Surgical Package
    According to CPT, the surgical package includes the following:

    -The surgical procedure;
    -Local infiltration, metacarpal/ metatarsal/digital block or topical anesthesia;
    -One related evaluation and management (E/M) encounter (including history and physical) that occurs after the decision for surgery has been made and is either on the date immediately prior to the procedure or on the actual date of the procedure;
    -Immediate postoperative care, including dictating operative notes and talking with the family and other physicians;
    -Writing orders;
    -Evaluating the patient in the postanesthesia recovery area;
    -Typical postoperative follow-up care.

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