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Post Operative

Coding Pearls -  Using the 58 Modifier Appropriately Modifier 58 v Modifier 78
Coding

Coding Pearls - Using the 58 Modifier Appropriately Modifier 58 v Modifier 78

by Michael Warshaw, DPM, CPC

My associate doctor recently billed for a hospital outpatient surgery: 28005 and 11981. The antibiotic spacer kept displacing during the p/o period, so he went back earlier than expected to do the following, hence the patient is still in the post operative global period from the first set of procedures: 28755 -- 58,RT -- M10.9 20705 -- 58,RT -- M86.9 11750 -- 79,T5 -- L60.0 Is this coded correctly with regard to modifiers and diagnosis codes? I personally have never done a staged procedure, and I know my billing company probably won't know either, so I figured I'd ask here first before submitting and getting hit with denials.
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Post Operative Wound Care
Coding

Post Operative Wound Care

by Michael Warshaw, DPM, CPC

“I was consulted on a patient in hospital with a large 5th metatarsophalangeal joint ulceration. There was osteomyelitis of the proximal phalanx and metatarsal head. I performed the resection and subsequently performed a delayed closure several days later. The closure left an area open due to soft tissue deficit. This necessitated post operative wound care. I initially billed CPT 28810 and then subsequently CPT 13160. I billed CPT 11042 weekly post operatively, until the wound healed. The private insurance states that all the CPT 11042 billings are considered part of the global. Is there a modifier for submitting related charges for necessary services?”
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New Consult on a Post Operative Patient
Coding

New Consult on a Post Operative Patient

by Michael Warshaw, DPM, CPC

“How do you code for a hospital consultation when the patient is in the postoperative global period from another surgeon? I was called to the local hospital to see a patient that was transferred for medical treatment for an unrelated condition. He had a transmetatarsal amputation (TMA) performed for apparent osteomyelitis at the other hospital by a different podiatric surgeon. I was consulted to evaluate the TMA site and make recommendations for management. How do I code the diagnosis and E/M for this post-operative consultation?”
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