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How you code this scenerio

  1. #1
    Default How you code this scenerio
    Medical Coding Books
    Pt comes in on Monday for infected insect bite. The Dr does I & D and pack wound. Has pt return next day for repeat of same. Pt continues to come in for next 4 consecutive days for same thing. Each day they note the progress of wound and change packing and dressing and administer topical meds. Done in office setting. What would you bill for the repeat visits?

  2. #2
    Default I&D with packing
    I would code that as 10061 - choosing the complicated code because packing was used. That would put the patient under a 10-day global period and additional office visits would be no charge (we use the 99024 w/V58.31), as long as it pertained only to repacking and follow-up care, with no complications arising.

  3. #3
    if he does the I & D each day, you would use the 76 modifier on your procedure each day.

  4. #4
    Duluth, Minnesota
    I agree with lphillips, as long as it pertained only to repacking and follow-up care, with no complications arising. You'd code the initial I & D, (complicated by the sound of it) - and the follow up visits within the global period would be no charges.
    on the other hand, if they did an I & D each time the patient comes in, and they knew they were going to do it again (told the patient to come back and we will do another I & D, packing, etc - then I would use the modifier .58 on the procedure code.
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  5. #5
    Milwaukee WI
    Default Modifier 76
    I think if it's a repeat I&D each day, modifier 76 is more appropriate.

    F Tessa Bartels, CPC, CPC-E/M

  6. #6
    If they do the I&D one day and just repack the wound on subsequent days, those visits would be part of the global. The 76 would be used if the I&D was repeated on the same day.
    Pam, CPC, CPC-P

  7. Default
    miscellaneous sevices such as dressing changes, incision care are components of a global surgical package and therefore those f/u services are not billable

  8. #8
    Question plastic surgeon - follow up wound care
    Quote Originally Posted by LMBOTT View Post
    Does the provider also try to bill an E/M level? I am having a problem with some provider education.

    Thank you,

    Lisa Bott CPC, CPC-H
    what if initial wound care was done by dr. A and then followed up by Dr. B? Two different practice locations but same Health care system. Our dressing change required use of a surgical tray,medication and dressing supplies. My questions is ; can i bill for surgical suplies as well as 99213 and 891.1. This was the first and last time patient will be seen in our office, because pt's lives out of out of town. The condition of the wound is serious enough for continual care. I realize it is within it's global time frame, but, couldn't i use a modifier and get paid? Any ideas on this?
    thks kt
    Last edited by krainko; 09-20-2008 at 10:15 PM.

  9. Default
    If it is the same practice, it is still global. Trying to place modifiers to get it paid is fraud. You simply cannot do it when it is under global, unless there is a complication.

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