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Billing E/M code during post op

Victoria Posted Fri 09th of December, 2016 10:36:54 AM
Is it appropriate to bill an E/M code if a patient comes in during post op period and has developed an infection related to the surgery?
SuperCoder Answered Mon 12th of December, 2016 02:06:02 AM

As per NCCI (National Corrective Coding Initiative) 2016, for major and minor surgical procedures, postoperative E&M services related to recovery from the surgical procedure during the postoperative period are included in the global surgical package as are E&M services related to complications of the surgery. Hence, cannot be a billable service. Postoperative visits unrelated to the diagnosis for which the surgical procedure was performed will be reported separately on the same day as a surgical procedure with modifier 24 (“Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period”).

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