Wiki Billing during global with different surgeons in same practice

[Ccgerson]

If one surgeon does a reduction in the ED, and another surgeon in the SAME practice takes over for follow up and subsequent ORIF, how is this billed?
Is modifer 54 used for reduction, or is this modifier ONLY used when post op care is with a diffferent group?
CMS and CPT guidelines for the modifier don't specify.
Thank you!
Cindy

 

[thomas7331]

For payment purposes, CMS considers all physicians of the same specialty and within the same practice to be the same provider. Modifiers 54/55/56 are used to split payment when a transfer of care takes place - it would not make sense to apply these within the same group practice since the payments are all going to the same entity - within a practice specialty, providers 'cover' each other, they do not transfer care. If you're coding for a service in the global period within your same practice, you should just apply the appropriate modifiers to any billable services during the global period (i.e. 24/58/78/79) or make the services a no-charge if they are inclusive to the global package.