tci General Surgery Coding Alert - 2007 Issue 9

Reader Question ~ Infection Isn't Necessarily 'Related'

Question: Nine days after a laparoscopic cholecystectomy (90-day global), a third-party insured patient was admitted for bile leak and developed peritonitis. May I charge for a consult for the follow-up and, if so, are any modifiers necessary? Wisconsin Subscriber Answer: The correct answer depends on whether your payer follows CPT (AMA) or CMS (Medicare) guidelines regarding postoperative complications.For payers following CPT guidelines, you must show that the E/M service (in this case, presumably an inpatient consultation, 99251-99255) that occurs during a previous procedure's global period is -unrelated- to the primary procedure (here, for instance, 47562, Laparoscopy, surgical; cholecystectomy)...

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