What Global Period to Follow

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March 1, 2012

Question:

Patient had a malignant lesion removed on the right neck. The wound size required the surgeon to harvest a split thickness skin graft. We know the lesion has a ten day global and the skin graft has a 90 day global period. Our question is: Since there are 2 separate global days, if the patient comes in for a recheck of the lesion after the ten day global period, can the surgeon bill for an E&M for the lesion re-check.

Answer:

This is a logical question based on the different global days. In this case, we recommend not reporting an E&M as the skin graft is “covering” the site of where the lesion was excised, thus the return visit is really focusing on wound assessment related to the skin graft and necessarily the lesion.