Primary Care Coding Alert
Lesion Excision Global
Question: Three days after having a lesion removed, a patient came in with an infection as a complication of the removal. I know there is a 10-day global period, so do the other seven days now cease to exist? Does the visit now become an E/M visit? Rhode Island Subscriber Answer: From a coding perspective, the postoperative visit for treatment of the infection is not part of the procedure and should be separately reported using an E/M code. CPT states that the "surgical package" associated with surgical codes includes "typical postoperative follow-up care." CPT also states, "follow-up care for therapeutic surgical procedures includes only that care which is usually a part of the surgical service. Complications, exacerbations, recurrence, or the presence of other diseases or injuries requiring additional services should be separately reported."
Note that not all payers follow this guidance. For example, Medicare considers "all additional medical or surgical services required of the surgeon during the postoperative period of the surgery because of complications which do not require additional trips to the operating room" to be part of the global surgical package and thus not separately reportable for Medicare purposes. (See Medicare Carriers Manual section 4821.A.)
Primary Care Coding Alert
- Cast Away Denials With Casting and Strapping Rules
There are no bones about it: Coding for casts and strapping instead of fracture care [...] - Modifier Madness:
Clear Up Confusion Over Modifiers -51 and -59
Modifiers -59 (Distinct procedural service) and -51 (Multiple procedures) have heads spinning, and the convoluted [...] - You Be the Coder:
Coumadin Coding
Test your coding knowledge. Determine how you would code this situation before looking at the [...] - Test Your Knowledge:
Coding Modifiers -51 and -59 Case by Case
Test your modifier knowledge. Determine how you would append this situation before looking at the box below [...] - Reader Question:
Cerumen Removal With E/M
Question: A patient came in complaining of congestion in his ear. After examining the patient [...] - Reader Question:
Injection and Nurse Visit
Question: When a patient comes in for a Depo-Provera injection, one of our physicians charges [...] - Reader Question:
Lesion Excision Global
Question: Three days after having a lesion removed, a patient came in with an infection [...] - Reader Question:
Extra Emergency Time
Question: A new patient came into the office with a laceration of her forearm. The [...] - Statement of Ownership, Management, and Circulation
