Part B Insider (Multispecialty) Coding Alert

Published on Sat Aug 12, 2006 PDF

Confused about global periods? You-re not alone. Carol Pohlig, a senior coding and education specialist at the University of Pennsylvania-s department of medicine in Philadelphia offers a couple of tips:

1) Know who is bound to the global period. Many physicians, such as cardiologists and cardiothoracic surgeons, don't realize that the global period applies to every doctor in the same group, says Pohlig.

Example #1: A surgeon performs a coronary artery bypass graft. The cardiologists aren't bound by the global periods, since they-re not usually under the same tax ID. So they can report their services without a modifier.

Example #2: An electrophysiologist inserts an implantable cardioverter defibrillator (ICD) or pacemaker. If the general cardiologist, who manages the patient's hypertension, sees the patient during the global, you-ll need a modifier. This is because the electrophysiologist and general cardiologist will usually report under the same tax ID, says Pohlig.

2) Know your carrier's modifier 24 policies. Some Part B carriers won't recognize the 24 modifier (E/M by same physician during post-op period) during the same hospitalization where the procedure occurred, says Pohlig. Those carriers will only recognize the 24 modifier after the patient is discharged for office visits or subsequent hospitalizations.