Practice Management Alert

READER QUESTIONS:

Count H&P in Global for Surgery

Question: I understand that I cannot bill for an H&P if there is a global because it is included in the surgery. Can we bill for an H&P if there is no global period? California Subscriber Answer: You cannot separately bill for the history and physical (H&P) your physician performs even for a procedure with a zero-day global period. Even when there is no global period associated with a code, there is an inherent E/M built into the fee for the code and as such this H&P is not a billable service. Bottom line: Every code's global package includes the preoperative work performed by the physician before the procedure or service. Therefore, unless the E/M service is significant and separately identifiable, you cannot bill it. Unless the office visit is medically necessary to reevaluate a condition, such as diabetes or hypertension, that may affect the proposed procedure, you should not [...]
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