Orthopedic Coding Alert

Question: A patient, who had a endoscopic knee repair presented at the emergency department 10 days post-op for pain management. Can we charge a consult or any ED fee? (The procedure has a global period of 60 days.)

Jon M. McMillan, MD

Answer: If the patient is a Medicare beneficiary, carriers will definitely consider this part of the normal, post-surgical problems. As such, the ED visit would be bundled into the global fee package. The only circumstance in which it would be billable is if the pain was from a new problem. Other payers may vary, so before you write it off, check with them to make sure.