Medicare Compliance & Reimbursement - 2011 Issue 1
Reader Questions: Infections May Transcend Global
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Article Overview
This reader Q&A addresses whether an infection-related follow-up visit after incision and drainage falls within the postoperative global period or may be reported separately. It explains the topic in terms of CPT guidance and Medicare’s general approach to services furnished during a surgical package, making it relevant to coders, billers, and compliance staff who work with postoperative encounters and evaluation and management services.
Why This Topic Matters
Postoperative visits can be difficult to classify when new problems arise during a global period, and the billing treatment may differ between CPT-based reporting and Medicare rules. Understanding the general scope of the guidance helps avoid incorrect bundling or inappropriate separate reporting for follow-up care and related complications.
Article Sections
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Question
The reader’s scenario involves postoperative infection care after a minor procedure and asks about the postoperative period and separate reporting of a visit.
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Answer
The response discusses the general relationship between postoperative infections, the global period, and separate evaluation and management reporting under CPT and Medicare frameworks.
What You Will Learn
- How postoperative infection visits are discussed in relation to a procedure’s global period
- How CPT and Medicare guidance may differ for services during postoperative periods
- What broad considerations affect whether a follow-up visit may be treated as separate care
- Which types of postoperative services are generally part of a surgical package versus potentially separately reportable
Who Should Read This
- Medical coders
- Professional billers
- Compliance staff
- Practice managers
- Physician office staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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