tci General Surgery Coding Alert - 2005 Issue 7

Reader Questions: Global Determines Postprocedure Coding

Question: Following surgery, we had to readmit a Medicare patient for a wound abscess. Can we charge for the readmission and daily care?Texas Subscriber Answer: If the surgeon readmits the patient during the global period of the original surgery for the same problem that prompted the original surgery, you cannot charge for the readmission or hospital visits.These rules apply specifically to Medicare. Medicare treats postoperative complications, including infections, differently than insurers that follow CPT guidelines. For payers other than Medicare, inquire about the insurer's guidelines regarding post-op complications.If, on the other hand, the patient's condition and...

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