tci Outpatient Facility Coding Alert - 2018 Issue 4

You Be the Coder: Include Non-OR Complication Treatment in Global Surgery Payment

Question: We have a patient present to our office for an infected incision site 10 days following a total knee arthroplasty (27447). The provider examined the infection site and prescribed antibiotics. Are we allowed to bill this out as a complication of the initial procedure? Michigan Subscriber Answer: According to Medicare's Global Surgery Booklet, there are numerous services which a coder should consider an inclusive component of the global surgery payment. Of these inclusive components, the following guideline pertains to the question at hand: "All additional medical or surgical services required of the surgeon during the post-operative period of...

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