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Otolaryngology Coding Alert

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Payer's Global Policy Determines Post-op I&D Allowance

Published on Fri Jan 08, 2010

Question: After having a septoplasty (30520, Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft) last week, the patient visited the office with a surgeryrelated hematoma. The doctor did not charge for the drainage. Two days later the hematoma returned andthe doctor's partner drained it in the office. The second ENT performed a repeat procedure and isn't receiving payment for the surgery. Should the first doctor have charged for the I&D? Can the second doctor report the service with modifier 77? New York Subscriber Answer: The answer is two-fold: CPT indicates that treatment for complications is not included in the global and is separately reportable. Medicare, however, considers complications part of the global and not  separately reportable unless they involve a return to the operating room. So, if your patient is not a Medicare patient and the patient's payer has not stated that it follows [...]
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