Ortho Surgery

Would this be in the global period? Patellar component removed. Two weeks later drainage from wound (which at this point NO infection was determined) Dr went back to OR and did deep I&D and wound reclosure. Not sure if I can bill for this and all codes for I&D post op wound seem to be for infections. Please I could use some direction. Thanks

I&d

Well, even though no infection was found, if the surgeon was doing a deep I&D, he must have went in under the impression that this was a developing infection. I would try and bill for it with a modifier -78. The diagnosis might be tricky...seroma, wound dehiscence, inflammation (if the doctor said there was any redness or swelling?) If you code denies, I might not pursue it to vigorously, but I think it's worth a try in this case, that was a lot of work on the surgeons part.

reply

CPT® Manual states in the surgery guidelines section that any complications, exacerbations, recurrence, or presence of other diseases requiring additional services are not included in the global period, so coders may report them separately.
However, CMS takes different approach. Per the Claims Processing Manual, chapter 12, any complications that develop during the global period related to the procedure are part of the global unless the patient returns to the operating room.