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Wiki Post op visit only - need dx

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WHAUN

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Nampa, ID
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Hi there, we had a patient come in that moved here from another state where she recently had MOHS w/ a flap closure. She just came in for a wound check as she was unsure the site was healing properly - it was just fine when our provider looked at it. We are billing 99202 w/ Z08 as primary dx but it is denying as Z08 cannot be used as a primary diagnosis. Is there any diagnosis that I can use as a primary to get this paid? Thanks!
 
I have used Z08 as primary with Z85.828 as secondary for follow-ups without denials. However, in this case, I would try using Z48.817 as primary with Z08 & Z85.828 as supporting diagnoses.

If there were any other findings, you could consider using L98.9. If sutures were removed, CPT 15853 could be added in addition to the OV.
 
I would agree with the above, just adding that if the prior procedure had a 90 day global, and your provider is now providing the postop care, you might consider G0559 in addition to E/M, If this was simply a straightforward wound check, or the required services were not provided, then just E/M.
G0559 Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the practitioner who performed the procedure (or in the same group practice) and is of the same or of a different specialty than the practitioner who performed the procedure, within the 90-day global period of the procedure(s), once per 90-day global period, when there has not been a formal transfer of care and requires the following required elements, when possible and applicable: reading available surgical note to understand the relative success of the procedure, the anatomy that was affected, and potential complications that could have arisen due to the unique circumstances of the patient's operation. research the procedure to determine expected post-operative course and potential complications (in the case of doing a post-op for a procedure outside the specialty). evaluate and physically examine the patient to determine whether the post-operative course is progressing appropriately. communicate with the practitioner who performed the procedure if any questions or concerns arise. (list separately in addition to office/outpatient evaluation and management visit, new or established)
 
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