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Thread: Complication During Global Period

  1. #1
    Join Date
    Apr 2007
    Grand Rapids, MI

    Question Complication During Global Period

    AAPC: Back to School
    I'm posting this in Gen. Surg. and E/M forums since it's a little of both.

    Medicare patient has lung cancer (162.9) and has a resection and segmentectomy (32504 and 32484) among other procedures with a 90 day global period. Approx 2 weeks later patient diagnosed with pneumonia (486) and seen several times by same surgeon as in-patient (99233) for treatment of pneumonia.

    Can I bill these subsequent hospital days to Medicare? The pneumonia may not be a direct complication of the surgery, but rather a complication of being in the hospital altogether. Are the dx's different enough to be considered non-related?

    If I can (or can't) - can you please give a link to whatever documentation you get your answer from?
    KLB, CPC
    "Sucess is not final, failure is not fatal; it is the courage to continue that counts." Winston Churchill

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Medicare

    My understanding is that Medicare will not pay for any complication and would probably consider the pneumonia directly related to the patient's surgery or recovery from surgery.

    F Tessa Bartels, CPC, CEMC

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