# Global Period with Different Provider/Same Practice



## dballard2004 (Aug 4, 2009)

I am auditing a chart and this issue has come up.  For this clinic, we have two providers.  Dr. A and Dr. B.  A patient came in to see Dr. A for a skin tag removal.  I am aware that there is a 0-10 day global period attached to this procedure.  My question is, the patient came in for follow-up three days after the procedure, but they saw Dr. B instead.  The providers are questioning this.  Does the global still apply to Dr. B since he did not do the surgery?  I say yes, but he coded this with a regular E/M and is questioning why it would be 99024 (my detemination).  Can anyone help me clearly explain this?  Thanks.


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## RGALVEZ (Aug 4, 2009)

First, does Dr. B have a subspecialty? Did Dr. B see this pt for the Tag Removal follow-up? If Dr. B has a subspecialty and did NOT see the pt for the Tag Removal, then you can bill an E&M. If he has the same specialty and the pt was seen for the tag removal F/U, then it is 99024.


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## CRC CPC (Aug 4, 2009)

I am with you.  If this is a f/u from skin tag removal it is a post op.
Colleen R Cox CPC


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## dballard2004 (Aug 4, 2009)

There is no subspecialty.  Both are primary care providers and the follow-up was for the tag removal.  I too thought that the global would still apply since this is the same specialty, but Dr. B states that the global period excludes services provided by other providers so the global does not apply to him.  I disagree and think 99024 is appropriate.  Thanks Ray and Colleen for your help.


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## LLovett (Aug 4, 2009)

I agree, CMS sees providers of the same specialty in the same group as the same person, this would be global.

Laura, CPC, CEMC


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## dballard2004 (Aug 5, 2009)

My thoughts exactly.  Thanks so much!


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## lcterry (Aug 14, 2009)

I am my partner and my partner is me.


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## krssy70 (Nov 5, 2009)

I was reviewing your question, and you want to keep in mind that if the patient came back for just the follow-up, then yes it will be global, but if the patient has a complication, ex: reaction to prescription, then use a modifier 24 on the E/M and it will get paid. Just make sure that it has a different diag than the initial procedural visit. ex: complication code...


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## RebeccaWoodward* (Nov 5, 2009)

krssy70 said:


> I was reviewing your question, and you want to keep in mind that if the patient came back for just the follow-up, then yes it will be global, but if the patient has a complication, ex: reaction to prescription, then use a modifier 24 on the E/M and it will get paid. Just make sure that it has a different diag than the initial procedural visit. ex: complication code...



Not for Medicare...(complication)

Many carriers follow CMS's global policy...you would need to check your payer to see if the follow CMS' global policy or CPT's


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