Anesthesia Coding Alert

Question: I need some help in figuring out what we can bill for our involvement with post-op care. Most of the surgeries have 90-day global periods. What do we need to help show that a visit is necessary care that’s due reimbursement rather than something that falls under the global period? For example, our pain management specialist might care for a wound that is compromised or infected, or one of the orthopedic surgeons in our multispecialty group might refer a patient to her for postoperative pain control. What is your advice?

Minnesota Subscriber

Answer: Appending a modifier such as 24 (Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period) might help in some situations, as long as you include clear documentation of the service your pain management specialist provided and why it was necessary.

Caveat: You cannot bill for separate postoperative care within the global period if it is related to the original procedure. You can, however, append modifier 24 to the E/M code for care for a problem that is unrelated to the original service.