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Wiki GYN Oncology surgeon
- Thread starter pjmcavoy
- Start date
Pam Warren
True Blue
Well, there are some schools of thought that support this, and others that don't. Here's what I've been taught with regard to surgical follow up.
I expect some healthy discussion....
The gu/onc surgery was for some gu-related condition, and it's unlikely that the surgeon knew the final outcome when he scrubbed in. The office visit is for Chemotherapy treatment/discussion, and althought related, not the same diagnosis. At the time of surgery, it may have not been known if, when, how much, what kind of chemo was appropriate....and not all GU/ Onc surgeries involve a chemo plan. So it's likely separate, and billable, with a -24. Also, a wound infection is not a normal part of any surgery, so if it's well over and above the normal wound-healing process, it's billable with the -24.
There are those that are way more conservative than I am, and believe that any service provided to a patitent following a major surgery is bundled into the major procedure, but I don't consider that to always be the case. Each case is different, and it all depends on being able to show separately-identifiable situations. From NCCI:
13. Treatment of complications of primary surgical procedures is separately reportable with some limitations. The global surgical package for an operative procedure includes all intra-operative services that are normally a usual and necessary part of the procedure.
I expect some healthy discussion....
The gu/onc surgery was for some gu-related condition, and it's unlikely that the surgeon knew the final outcome when he scrubbed in. The office visit is for Chemotherapy treatment/discussion, and althought related, not the same diagnosis. At the time of surgery, it may have not been known if, when, how much, what kind of chemo was appropriate....and not all GU/ Onc surgeries involve a chemo plan. So it's likely separate, and billable, with a -24. Also, a wound infection is not a normal part of any surgery, so if it's well over and above the normal wound-healing process, it's billable with the -24.
There are those that are way more conservative than I am, and believe that any service provided to a patitent following a major surgery is bundled into the major procedure, but I don't consider that to always be the case. Each case is different, and it all depends on being able to show separately-identifiable situations. From NCCI:
13. Treatment of complications of primary surgical procedures is separately reportable with some limitations. The global surgical package for an operative procedure includes all intra-operative services that are normally a usual and necessary part of the procedure.
hewitt
Expert
Well done! I agree with Pam. If proven to be a significatly, separate problem, code and bill it!