Wiki Inpatient visit and Debridement during global period

[lorettac]

Hi everyone,

The physician performed a Rt hallux amputation 28820-T5 on 04/05/2017. Understanding 90 days global applied to the procedure. Patient returned to office once a week for three weeks for post-op follow up which I reported as 99024. However, on the fourth week on 05/03/2017 follow up, patient developed a new wound on the left hallux. But two days later on 05/05/2017, patient was admitted through ER due to pseudo stroke. Since patient has the wound condition on both feet, so the physician was called in to the hospital. So for this visit on 05/05/2017, should it be reported as an initial hospital visit 99222 or still be reported as 99024? Then on 05/09/2017, physician performed a Lt hallux amputation 28810-TA, with a new 90 days global period begins. Then the surgical site developed skin infection, on the follow up visit on 05/31/2017, still under global, the physician performed a debridement 11043-50. Could debridement be billed separately with modifier 79 during global period and be paid? And debridement has 000 global period, would this override the existing postoperative period?

Thank you very much for your help and advice.

 

[thomas7331]

The initial hospital visit, assuming the documentation shows the service addressed the problems unrelated to the surgery (left toe wound, pseudo stroke), could be billed with modifier 24. The debridement however, falls within the 90-day global of both procedures and since it involves the same sites, modifier 79 is not appropriate. This service is included in the global period since it is a complication that does not require a return to the OR and does not meet the definition of a staged/related procedure either.

 

[lorettac]

The initial hospital visit, assuming the documentation shows the service addressed the problems unrelated to the surgery (left toe wound, pseudo stroke), could be billed with modifier 24. The debridement however, falls within the 90-day global of both procedures and since it involves the same sites, modifier 79 is not appropriate. This service is included in the global period since it is a complication that does not require a return to the OR and does not meet the definition of a staged/related procedure either.

Thomas, thank you so much for your reply! Appreciated!