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Audit-Surgery Guidelines/Surgical Package

  1. #1
    Question Audit-Surgery Guidelines/Surgical Package
    Medical Coding Books
    We have a doctor who performed a surgery with no internal fixation (90 day global).

    Day 13 he billed E/M (denied) with x-ray (paid)
    Day 50 he billed E/M (denied) with x-ray (paid)

    We expect to see more E/M and x-ray services within the 90 day global from this doctor for the same patient.

    This doctor has a tendency to over utilize/abuse his services for auto/WC. Is his billing practices within the guidelines?

    Any information/websites that have more detailed guidelines would be appreciated.
    Tina M Boback CPC

  2. #2
    Columbia, MO
    instead of the E&M code you should 99024 for post op visit this is a 0 paid but it correctly captured=s the encounter.

    Debra A. Mitchell, MSPH, CPC-H

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