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Hospital admission in post op period due to infection

  1. Default Hospital admission in post op period due to infection
    Medical Coding Books
    Can you bill the E/M in the post-op period for an admission to the hospital due to a post-operative cellulitis due to noncompliance? We have a patient who is status post ORIF ankle who did not keep his initial post-operative visit, and allowed his wound to get and stay wet causing the severe cellulitis. He was admitted for IV antibiotics. Is this billable and do I use the 24? Seems inappropriate when it is not really "unrelated".

  2. #2
    Milwaukee WI
    Default 24 modifier
    We would use the -24 modifier in a case like this because this is not considered routine postoperative care.

    However, Medicare (and some commercial carriers who are now following Medicare's lead) will not pay for any E/M service in the postoperative period - only for procedureing requiring a return to the OR.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    In this situation I would try it w/ a 24. I would make sure the documentation is specific that this is becasuse of the pt's noncompliance.
    adrianne, cpc

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