Incision pain

I have a visit where this patient had a chole done on 8/19/11. she comes in on 8/26 for Incision pain. Should I code this visit with a 998.89 since there is no signs of infection, she only has the pain. Please help. Thank you!

re: INCISION PAIN

You should not be billing this post-op visit as it is included in the surgical global package. If it is unusual pain, then you could bill 338.12 for acute post op pain or 338.28 for chronic but if it is the run of the mill postop pain, it can't be billed.

re: INCISION PAIN

I found the post op pain code so thats what i coded to. so should i tell my biller not to bill out this visit? This patient is on Medicaid too.

re: INCISION PAIN

I would not. I am sure Medicaid will deny it anyway.

re: INCISION PAIN

You would bill the post op encounter as 99024, the diagnosis could be reported in a few different ways. 99x.xx 338.xx or aftercare codes.

re: INCISION PAIN

Yes, 99024 is used for internal auditing. It won't be billed to the insurance company.

re: INCISION PAIN

Thank you so much for clarifying my complicated visit. I really appreciate your quick response!

re: INCISION PAIN

You are welcome.