# removing Granulation tissue



## rleif1sun (Jul 16, 2018)

at post partum visit provider removed granulation tissue using forceps *without* silver nitrate. is it included in visit for can be billed separately? which CPT code?


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## annievof (Jul 18, 2018)

*Up your E/M*



rleif1sun said:


> at post partum visit provider removed granulation tissue using forceps *without* silver nitrate. is it included in visit for can be billed separately? which CPT code?



 Hi there! 
So the 17250's main purpose is to reimburse for the silver, not so much for the work.  This would be a case of needing more information from the provider.  Did he repair, debride, any additional work, or did he merely remove a piece of tissue from the perineal wound?  If it were me, and there were a few extra items used (forceps), and minutes taken, then I would just add an appropriate leveled E/M with a mod 24.  Just remember to have your L92.8 coded, and have documentation to support your claim, in case they request it.
Good luck!  
*Annie Daniel, CPC, CPMA, CEMC*


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## rleif1sun (Jul 20, 2018)

*up code*

but the postpartum visit is included in delivery code(59400,59510) therefore no E/M is coded on claim.


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## thomas7331 (Jul 20, 2018)

Post-operative wound management is considered part of the global package by most payers unless it involves a return to the O.R.  It shouldn't be billed separately, and a modifier to exempt it from the global period would not be supported unless the documentation supports that it is clearly unrelated to the original procedure.  I believe this would be true whether or not silver nitrate was used.


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