EM Coding Alert

Question: For a postoperative, related evaluation and management (E/M) visit within the global surgery period, should I still submit the claim to the payer despite the inevitable denial? Or is it common practice to code the claim and then immediately write it off?

Montana Subscriber

Answer: In the case of postoperative E/M visits, you should check your practice’s guidelines as to whether it typically bills for (related) postoperative claims within the global period. Regardless of whether you end up submitting to the payer, you should use code 99024 (Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure) for postoperative services that are included in the original surgery’s global surgical package. Code 99024 should have a zero-dollar value, adding nothing to the patient’s ledger.

Additionally, you should check your Medicare Administrative Contractor (MAC) or other payer guidelines. These policies vary from MAC to MAC and insurance company to insurance company, and you may be required to submit the claim despite the zero charge. Since this is a zero-charge code, your submission of this claim to the payer would be for documentation purposes alone. Make sure you clearly understand what services are and are not included in the 10- and 90-day global surgery periods.