inpatient I&D

My surgeon admitted a patient with cellulitits and plan was to give iv antibiotics. On day 2 an abscess formed and an I&D was performed. I realize an I&D has a 10 day global period....the patient was in the hospital 4 more days after the I&D. Can I bill for hospital sub visits and a discharge since there is a 10day global? If so do i need modifiers?

inpatient I&D

If the code has a ten day global period, none of the subsequent hospital visits or discharge day can be billed.

I&d

Slightly more interesting question: In my state the I&D pays $91 (medicare rate)...lowest level hospital visit pays $40. Could you (ethically, legally, etc.) not bill the I&D ($91) and instead bill the four subsequent visits at a low level (for a total of $120). If you don't bill the I&D, there's no global to worry about. It just seems stupid to me, that you would do a simple procedure, and have to follow the patient for many days and be locked in to a global. Stupid, stupid system.

I&d

I would think not billing for the I&D would not be the right or should I say "legal" thing to do. It does seem stupid to me not to be able to bill for hospital care after a "simple" procedure!

Inpatient I&D

Just to play devil's advocate here:

You should select a CPT code that most accurately describes the service performed, and not the one that pays better. (We've all seen in the past: 99211 instead of an injection, and it's wrong).

But, if a physician performs an inpatient admission, two subsequent visits, a discharge and an I&D, which most accurately describes the physician work:

the E/M services

The I&D

Don't eat me!! I'm asking!

Asking

To take it a little further:
Cellulitis is a common, potentially serious bacterial skin infection. Cellulitis appears as a swollen, red area of skin that feels hot and tender, and it may spread rapidly.
An abscess is a localized collection of pus that generally develops in response to infection. An abscess is typically painful, and it appears as a swollen area that is warm to the touch. The skin surrounding an abscess typically appears pink or red.
Although they sometimes occur together, they are different disease processes requiring different treatments. An abscess is treated with incision and drainage and may not require antibiotics; Cellulitis is treated with antibiotics alone.
So, you could have the admit for cellulitis, the I&D for abscess (modifier -25), and the subsequent visits and discharge for cellulitis treatment------------