General Surgery Coding Alert

READER QUESTIONS:

Payers Treat Group Practices as 1 Provider

Question: If Surgeon 2 in our group practice provides post-op care for a patient whom Surgeon 1 operated on, can Surgeon 2 bill for his services?


North Carolina Subscriber

Answer: Payers will treat two physicians within a practice as one when caring for a patient. Therefore, when one physician from a practice performs an operation, and another physician from the same practice performs the postoperative follow-up, you may not report the follow-up care separately.

But if one physician from a practice performs an operation, and a second physician from the same practice needs to take the patient back to surgery for a complication within the global period, the second surgeon may report the procedure by appending modifier -78 (Return to the operating room for a related procedure during the postoperative period) to the appropriate CPT code.

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