Hospital

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.

“My group takes call at our local hospital, and this necessitates seeing patients in the emergency room (ER) on occasion. We are not all in agreement regarding what E/M codes should be used in this scenario. We have come up with different encounters: -A patient seen in the ER. The patient is then discharged to follow up for outpatient care. -A patient is seen in the ER and then admitted for continued medical treatment. -A patient is seen in the ER and emergently taken straight to the operating room for surgical treatment. What E/M code series would you recommend using for these different scenarios? Thank you for the help!”

“After watching some E/M presentations, it was suggested that hospital consultations should be billed with CPT 99252-CPT 99255. When we billed these codes, our EMR system and our clearing house rejected the codes. They are saying effective 1/1/2010, CMS has announced that they will reject these codes. Are we billing the right codes?”