Forum - Questions & Answers

Aug 9th, 2011 - michelle.advancedortho 2 

Post Op aspirations

During a patient's post operative period, if they need an aspiration and injection, how would that be billed out? And would we likely get reimbursed for that?

Aug 9th, 2011 - DebraS   67 

re: Post Op aspirations

If the patient had let's say, knee sx. Swelling and fluid buildup is expected/anticipated so the aspiration and injection would be a complication of the surgery and not billable. However, if it's not related to the surgery, different dx, different part/compartment of the knee then it could be billable with a -24 on the E/M as unrelated E/m and a -79 on the injection for unrelated procedure. It depends on what the dictation reads and supports so just throwing guesses out there without knowing whats documented. Sometimes the dictation tells a different story than the question itself.
Not included in global package: Treatment of an underlying condition that is not part of NORMAL recovery.

Aug 10th, 2011 - firefly 8 

re: Post Op aspirations

Medicare does not remit for any service related to a surgical procedure for which a patient is within an established global period unless the service(s) result in a return to the OR in which instance we must append modifier -78. In the event, an unrelated service such as an E/M is rendered within an established global period, modifier -24 must be appended and if a procedure such as an injection is rendered, modifier -79 must be appended to the injection.



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