Wiki Aftercare (suture removal, dressings, etc.)

[pinnaclephyserv]

Should I just bill E/M code for aftercare sx that was performed by another physician in another state?

Thanks in advance for any help.,

 

[CodingKing]

If its still in the global period and there was a transfer of care for the post-op portion then you would report the original surgical procedure with modifier 55 for Postoperative Management Only.
The other provider should be reporting the procedure 56 & 59 for pre-op and inter-op. Though typically the surgeon fails to code the modifier showing the transfer of care, so you will probably need to contact original surgeon to correct their claim when yours rejects.

 

[pinnaclephyserv]

There was no transfer of care. The patient was in another state and was injured, so he's home to have post op care. I am pretty sure the surgeon did not bill with modifier 54.
Thanks

 

[CodingKing]

Surgical treatment where injury occurred and follow-up at home is the definition of transfer of care. You will need to work with the primary surgeon to make sure they did not report the full global package . If it was as simple as just removal of suture then it could be billed under a nurse visit 99211.