E/M During Global Period for Diabetic Foot Ulcer Following Total Metatarsal Amputation

Question:

If a patient has a total metatarsal amputation for diabetic foot ulcer and he gets readmitted for another condition, but then vascular surgery is consulted for his original underlying condition of DFA and now is treating the ulcer at the amputation site, 80 days post-op is the E/M billable? The TMA surgical wound is healing . The right plantar DFU stage 3 Wagner needs debridement and dressing changes.

Answer:

The evaluation and management service is not separately billable because it appears to represent continued management of the same surgical and disease process that prompted the original total metatarsal amputation. Any care directed toward the amputation wound or related diabetic ulceration in the same region during the 90-day global is included in the global period.

*This response is based on the best information available as of 11/20/25.