Wound care

[MARTHAY_17239]

I need some clarification on billing for wound care when patient is still under the post op period. I have a patient who underwent a Pilonidal Cyst CPT code 11772 on 6/1/21 the patient has been coming in to see the wound care nurse on a weekly basis. Our office staff is wanting to bill for the wound care services is this something we can bill for if the patient is still under a global period?

 

[Alicia]

11772 - Excision of pilonidal cyst or sinus; complicated
Example #1: Type of Procedure

CPT Assistant Archives​

The patient sees the surgeon initially in the office because of an infected pilonidal cyst. The cyst is incised and drained at the first visit. Either of two codes, (10080*, 10081) would be reported for the surgery, depending on how extensive the incision and drainage was.

10080

Incision and drainage of pilonidal cyst; simple
10081complicated
Depending on the third-party payor, there may be a global postoperative period for each of these procedures. If a decision is subsequently made to excise the pilonidal cyst, the global postoperative period from the incision and drainage may overlap with the preoperative period related to the excision of the pilonidal cyst. When and if the excision of the cyst is performed may influence the preoperative global surgical package by some third party payors (ie, the global period for 10081 may overlap with the preoperative period related to 11772).

After the infection is treated, the decision is made by the surgeon to excise the cyst. The excision of the pilonidal cyst takes place three weeks after the initial incision and drainage. Code 11770, 11771, or 11772 is reported, based on the complexity of the excision. The length of the global period may vary by code number as well as by third-party payor (eg, the physician in the above example could be performing a second surgical procedure during the period of global surgical postoperative care for the first procedure).

11770 Excision of pilonidal cyst or sinus; simple
11771 extensive
11772 complicated

 

[MARTHAY_17239]

11772 - Excision of pilonidal cyst or sinus; complicated
Example #1: Type of Procedure

CPT Assistant Archives​

The patient sees the surgeon initially in the office because of an infected pilonidal cyst. The cyst is incised and drained at the first visit. Either of two codes, (10080*, 10081) would be reported for the surgery, depending on how extensive the incision and drainage was.

10080

Incision and drainage of pilonidal cyst; simple
10081complicated
Depending on the third-party payor, there may be a global postoperative period for each of these procedures. If a decision is subsequently made to excise the pilonidal cyst, the global postoperative period from the incision and drainage may overlap with the preoperative period related to the excision of the pilonidal cyst. When and if the excision of the cyst is performed may influence the preoperative global surgical package by some third party payors (ie, the global period for 10081 may overlap with the preoperative period related to 11772).

After the infection is treated, the decision is made by the surgeon to excise the cyst. The excision of the pilonidal cyst takes place three weeks after the initial incision and drainage. Code 11770, 11771, or 11772 is reported, based on the complexity of the excision. The length of the global period may vary by code number as well as by third-party payor (eg, the physician in the above example could be performing a second surgical procedure during the period of global surgical postoperative care for the first procedure).

11770 Excision of pilonidal cyst or sinus; simple
11771 extensive
11772 complicated

CPT 11772 has a 90 day global period so all the wound care that is done during the 90 days is not billable?

 

[Darcy]

CPT 11772 has a 90 day global period so all the wound care that is done during the 90 days is not billable?

Correct