tci Medicare Compliance & Reimbursement - 2011 Issue 7

Reader Questions: Disease Counseling May Qualify You for Post-Op Pay

Question: We had a breast biopsy patient with a breast cancer diagnosis who had an office visit during the post-op period to discuss treatment options (not for surgical follow up). Can I bill for this office visit during the global period, and what diagnosis code should I use to indicate that the service was unrelated to surgery?Answer: Yes, you can separately bill an office visit for treatment counseling during the post-op period. You should code the underlying diagnosis -- 174.x (Malignant neoplasm of female breast). The global package does not include treatment directed at the underlying disease...

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