Patient comes in after getting bandage wet following surgery, which wasn't originally scheduled, now needs an antibiotic for an infection. Can an E/M be billed?
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I have to respectfully diagree. Despite the stupidity or ignorance of the patient or even if accidental, unfortunately a wet bandage and subsequent infection is part of the global component for a procedure within its global period (10 or 90 days). Certainly if the initial global was zero days, then certainly an appropriate e/m can be billed with no modifier.
Assuming the same patient had to go to a similar POS for a subsequent procedure, then the surgical procedure performed could be billed with a 78 (related to original procedure).
Let's raise another question somewhat related to this and see what you think:
Assuming this second procedure was done and had a zero day global, would further visits related to the second procedure be billable with a 24 modifier or would the original global period apply?
What are your thoughts?
The admininstrators at Dr Line have researched the answer to this question, but we wonder what your answer is?
Please let us know.
This issue requires me to ask you some questions as the answer is predicated on having all the facts.
Was this surgery patient's infection you asked directly involving the superficial infection in the surgery incision? It matters when it comes to Medicare, but you did not say who the insurance was for this issue.
2. If they have a policy similar to Medicare, what is considered part of the global?
3. What insurance plan specifically did the patient have?
Since this is a new problem not directly related to the surgery, you can bill an office visit. You would need to use the modifier -24 (unrelated evaluation and management service by the same physician during the postoperative period). You can use the infection code as the diagnosis.