Wiki Postoperative billing

[mfranks]

I need some input on this situation that I am dealing with. I have a surgeon that I work for that is constantly trying to get me to bill for his postop visits stating that the patient came in with cellulitis. As far as I can tell that should be considered a postop complication as the patient wouldnt have the cellulitis if they had not had the surgery. He insists that it should be billed for. Any advice???

 

[cheermom68]

If the patient is Medicare, you cannot bill for anything related in the post op global period, unless the patient goes back to surgery. Under CPT guidelines for commercial insurance there is the possibility of billing for complications if they are outside of the typical postoperative foolow up care. Refer to the CPT surgery guidelines and the CMS global surgical package guidelines.

http://www.cms.gov/Outreach-and-Edu...oducts/downloads/GloballSurgery-ICN907166.pdf