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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.

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.

In my experience you need to reach out to that specific insurance company and request a meeting with their vice president of contracting. You can't just go and say I want to be paid more, but instead you explain key facts about your practice and how your practice saves them money. Do some internal research and first see how much that commercial insurance means to your practice revenue. If the revenue is less than 10%, consider even dropping that plan filling those seats with better paying plans if there is no option for negotiating. Do you treat diabetics and keep them out of the hospital or prevent amputations, if so, show in real dollars how much you have saved the insurance over the years and make the point that it is time for you to update your contract. It is imperative when you negotiate rates that you use a specific fee schedule, most will go with a Medicare fee schedule. So, pick the Medicare year that you got paid the most and request 165% of the Medicare schedule, it is a negotiation, and it may take 3 or more tries over several months of back and forth to get you to a favorable fee schedule. Don't sell your services short. Don't accept the first offer. This information provides a good start on the path to better reimbursement.

for injections on neuromas do you need to add foot modifiers?