Otolaryngology Coding Alert

Question: One of our physicians wants to book patients for the first post-op visit following ear tube insertion for after the 10-day global period so we can bill an office visit. I believe the first visit should be considered a post-op if you bring the patient in after the post-op period (i.e., two weeks later to let the inflammation resolve). What are your thoughts on this? 

Connecticut Subscriber

Answer: If you are billing the global surgical code, then you’ve already charged for the post-op visit because those visits are included in your global charge and reimbursement. Billing for the first post-op visit would essentially be collecting twice for this normal service (first when you bill and collect for the global surgical code and then again when you arrange to have the patient come back outside the global days attached to the procedure). That could be considered improper billing practice.

Note: This way of thinking does not apply when you schedule a follow-up visit for a patient who underwent a procedure that does not have a global period, such as a diagnostic laryngoscopy (31525, Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn). You can bill for any associated services following the procedure.