# Billing post-operative care



## crystalm (May 15, 2008)

Hi.  We have a situation that came up in our office that we are unsure on how to code.  We have an orthopedic physican who comes to our facility 5 days per month.  He is contracted through our clinic, and we do the coding and billing for anything he does while here.  He is not a locum.  He also practices in another town near here and does a lot of his surgeries there.  The problem we are running into is, can we bill post-operative care when it is done in our facility, when the surgery was performed in another town, but by the same physician?  Would we want to append the modifier -55 to this?  Any suggestions would be appreciated!


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## Treetoad (May 15, 2008)

I would think that since the same provider performed the surgery is also doing the follow-up, it would be global regardless of where he sees the patient.

~L


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## mbort (May 16, 2008)

I agree, it doesnt matter what town he sees them in, its still post op 99024


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## Ltubia (Apr 6, 2013)

*Cite Proof?*

Can anyone cite any "proof" of how to do this?  I have been researching for a smiliar situation, and I can't find anything.


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## OCD_coder (Apr 8, 2013)

Same physician/surgeon, same Tax ID#, regardless of where he sees the patient - it is global.

Authorative Source:
Medicare Global Surgery Fact Sheet


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## kagal0816@verizon.net (Apr 11, 2013)

*Bill for Post Op Care?*

If the patient is in a global period for a surgical procedure that the Physician performed, what billable service would the patient be receiving?  If the modifier 55 is appended, the surgery billing would need to include a 54, and reimbursement would be reduced.

I am sorry, but perhaps I am not understanding the situation.  From your post:
_"The problem we are running into is, can we bill post-operative care when it is done in our facility, when the surgery was performed in another town, but by the same physician?" _

If the surgeon performs a procedure in a facility that is yours, as an employee of yours, why would/should there be any additional reimbursement due to the clinic?  Just wondering.  

Karen Gallagher, CPC, COSC


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