Wiki infected c-section site

[rleif1sun]

Patient had c section delivery due to placenta previa, returns 21 days later in office c/o discharge discoloration red/yellow for 1-2 days. Antibiotics to be given keflex 500mg bid for 10 days. Patient educated on how to release discharge from csection site as well as soap and water when washing site twice daily. To apply gauze after cleaning site with soap and water, also peroxide can be used as well.
can i bill this separately or is it included in global package?

 

[csperoni]

This depends on whether carrier follows CMS global guidelines or AMA global guidelines. This is one of those scenarios with different guidelines.
CMS states complications are not separately billable unless they require a return to the OR.
AMA states complications are separately billable.
All of my insurance contracts specify CMS billing rules.