My main question is why are these injections being performed? Are they being performed for pain management or are related to the diagnosis for the original surgery? Or are these being performed for a completely different reason than the original surgery?
If these injections are being performed for a completely different reason then these are billable. However, if these injections are at all related to the diagnosis (or reason) for the original surgery then these are not billable.
Per
CMS:
What services are included in the global surgery payment?
Medicare includes the following services in the global surgery payment when provided in addition to the surgery:
-All additional medical or surgical services required of the surgeon during the post-operative period of the surgery because of complications, which do not require additional trips to the operating room
-Follow-up visits during the post-operative period of the surgery that are related to recovery from the surgery
-Post-surgical pain management by the surgeon
What services are not included in the global surgery payment?
The following services are not included in the global surgical payment. These services may be billed and paid for separately:
-Visits unrelated to the diagnosis for which the surgical procedure is performed, unless the visits occur due to complications of the surgery
-Treatment for the underlying condition or an added course of treatment which is not part of normal recovery from surgery
-Treatment for post-operative complications requiring a return trip to the Operating Room (OR). An OR, for this purpose, is defined as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient’s room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient’s condition was so critical there would be insufficient time for transportation to an OR)
Also, in order to use modifier 58, Medicare requires a return trip to the OR. Medicare defines an OR as a place of service specifically equipped and staffed for the sole purpose of performing procedures.
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