Procedure

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.

“I have a patient who had a hammer toe deformity, and this required repair of the second toe. Unfortunately, the surgical site developed osteomyelitis. This complication occurred at postoperative week number four. I returned to the operating room to perform an amputation of the second toe because of osteomyelitis. I would like to hear thoughts on the appropriate modifiers. And how does the zero-day global period for the amputation play into the billing for the post operative care?”

“I performed a partial 1st ray amputation that included the hallux and part of the 1st metatarsal. The site did not heal, and a new infection developed at the amputation site. The result is a return to the operating room for a right trans-metatarsal amputation. For the subsequent surgery, I used Modifier 78. After all, this was an unplanned return to the operating room. I evaluated the patient post operatively and I am wondering which date should I be using for the 90-day global period?”