# Pre-Op during global period



## cmac (Apr 20, 2009)

Patient came in for new pt visit on 4/15/09 for abcess/contusion on knee. After evaluation Dr performed I&D, pt now in a 10 day global period until 4/25/09. Pt came back on 4/17/09 for a pre-op, she now has to have surgery on her knee for this problem. (she saw surgeon after 1st appt here and he decided she needed surgery). We, as her primary care doc., have to do the H&P for her surgery. 
Pt has Medicare and I've had problems before getting visits paid during the global period. 24 modifier is what I've used in the past and it does not get paid. Any suggestions on how to bill this? Modifier? 
Any help is appreciated. 
Thanks!


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## FTessaBartels (Apr 20, 2009)

*Surgeon should do his own H&P*

The surgeon should be doing his own H&P.

IF the patient has some co-morbidity for which the surgeon is requesting a consult from your physician prior to surgery (e.g. diabetes or cardiac issues), then you would have a consultation (which still would not be the H&P). 

-24 modifier would be correct but I don't know how to force Medicare to pay for this service. 

I can't help but notice that these two visits are just 2 days apart (first visit w/ I&D was 4-15;  she's back on 4-17).  I can't help but wonder what the rush is?

F Tessa Bartels, CPC, CEMC


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