Results 1 to 4 of 4

post of complication question?

  1. #1
    Post post of complication question?
    Medical Coding Books
    A patient was admited to the hospital for complications from her surgery that she had 15 days earlier. 99253/24 was billed and the insurance denied it as inclusive. Was wondering if anyone had any modifier suggestions,or if this was even billable, or is included in the post op global period?

  2. #2
    When complications arise they are considered incidental and bundled into the procedure for the global period (0, 10 or 90 days). In situtations like this I don't bill for it, however if you ever do come across a situation where the pt was re-admitted for a different reason you would use modifier 24.
    adrianne, cpc

  3. #3
    Default Carrier's other than medicare
    Is complications always included in the global or is this just a medicare thing ?? I don't bill it also because it was my understanding that any complications are included in global but i was told that some carriers will pay.

  4. #4
    North Carolina
    Often, it depends on what guidelines the carrier is following. In your scenario, it seems as if the carrier is following Medicare guidelines.

    CPT-Not included:

    Typical postoperative follow-up care.

    CPT states that "typical postoperative follow-up care" includes only that care which is usually a part of the surgical service. Complications, exacerbations, recurrence, or the presence of other diseases or injuries requiring additional services should be separately reported


    All additional medical or surgical services required of the physician during the postoperative period of the surgery because of complications not requiring additional trips to the operating room

Similar Threads

  1. Post Op Complication
    By JRalston in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 05-22-2015, 03:40 PM
  2. post op complication
    By carmstrong in forum OB/GYN
    Replies: 1
    Last Post: 08-12-2013, 03:58 PM
  3. Post Op Complication
    By okandy in forum Podiatry
    Replies: 4
    Last Post: 10-25-2010, 12:49 PM
  4. Post-op Complication
    By Katmiller in forum Diagnosis Coding
    Replies: 0
    Last Post: 07-29-2010, 07:50 AM
  5. post op complication
    By sdorsey in forum OB/GYN
    Replies: 3
    Last Post: 03-03-2010, 01:51 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
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.