Practice Management Alert

Question: If my doctor performs a surgery with a 90-day global, and he has subsequent hospital visits that are related to the surgery, are those hospital visits included in the 90 surgical global period?

Wisconsin Subscriber

Answer: In the scenario you give, all postoperative visits during the surgery’s 90-day global period as well as the day before surgery and the day of surgery are included in the reimbursement for the surgical procedure itself.

Under rare and rather unusual circumstances, if a hospital visit is completely unrelated to the post-operative care, you can bill for a hospital E/M visit and apply modifier 24 (Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period).

Example: Following an in-hospital yttrium aluminum garnet (YAG) laser procedure, just report the same code (66821, Discission of secondary membranous cataract [opacified posterior lens capsule and/or anterior hyaloid]; laser surgery [e.g., YAG laser] [one or more stages]) on his right eye, a patient develops conjunctivitis in his left eye before discharge. In this case, you could report the hospital visit for the unrelated conjunctivitis using modifier 24 on the in-hospital E/M visit.