tci Outpatient Facility Coding Alert - 2013 Issue 1

Reimbursement: Know Your Patients' Payers to Capture Legitimate Post-Op Revenue

Don’t automatically skip billing for post-surgical infection care. Wondering whether services associated with a postoperative complication are included with the original procedure or can be coded separately? If so, two simple tips will help you determine when you should bill for post-op care. Tip 1: Divide Your Medicare and Non-Medicare Patients Medicare treats postoperative complications (such as infections) differently than insurers who follow CPT® guidelines. Although both CMS and CPT® guidelines indicate that the global surgical package includes "typical" postsurgical care, they have different stances on what constitutes "typical" -- which means you must differentiate claims depending on...

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