Wiki Aspiration after Total Knee Replacement

[sbarbour3]

My boss says we shouldn't use a 79 modifier to bill for an aspiration of the knee in the global period of a total knee replacement. I was taught that an unplanned procedure in a post op period was not part of the surgery charge. Should we be using a 78 modifier even though we are doing the aspiration in the office? Or should we just not be charging at all?

 

[thomas7331]

If the procedure was done in the office then modifier 78 would not be appropriate as that requires a return to the OR. Modifier 79 is appropriate only if the procedure is unrelated to the global period of the knee replacement. If the injection is related to the knee replacement (e.g. is for treatment of post-operative pain or other complications of the procedure) then it should not be billed as that is considered included in the global surgical package per the CMS policy.