Wiki Billing in 90 day post op / separate specialties

[wavesograin]

Patient has major 90 day global surgery by neurosurgeon as IP. After surgery, pt was discharged from IP hospital, location 21, and transferred to Rehab hospital, location 61, where pt was followed by rehab/physical medicine physician. Workers' Comp is denying the Rehab physician's charges for global to the surgery.
Is this correct, that a separate specialty may not bill in the post op period, for the same Dx as the surgery? Does each provider need modifiers indicating surgery only / postop only?

 

[ajb1986]

No thats not correct. The global period only affects the practice that performed the surgery. So the surgeon's cannot charge anything to a patient during the global period unless the patient has a change in condition. For example if the patient needs a new imaging study done, they still have to pay their portion and global period rules do not apply.

Worker's comp is really a pain because everything has to get preapproved and authorized. The rehab facility may try the 55 modifier but workers comp tends to be difficult especially in matters of rehab and physical therapy. The patient may have to go to a different facility that takes that particular workers compensation plan.