tci ED Coding & Reimbursement Alert - 2013 Issue 5

Reader Question: Adverse Reaction Pay Depends on Insurer

Question: The ED physician performs simple repair of a 4.6cm-laceration on a patient’s right shoulder. Two days later, the patient returns complaining that his wound is inflamed and painful. The physician finds an infection in the patient’s shoulder and treats the wound with antibiotics. Can we charge a patient visit in this scenario? Kentucky Subscriber Answer: Medicare has changed the global surgical period for simple lacerations to 0 days. Typically Medicare bundles most clinical services that occur during the global period unless they are major complications requiring a return to the operating room or distinct and...

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