Wiki Charges during global by different physician

[bridgeway21]

We have a patient who was out of state and fractured his right wrist and had fracture care in that state. During the 90 day global he comes into our office for a problem with his leg/ankle. While here we did remove the cast on the wrist. Since this is during the global for the fracture care (although my doctor was not the treating physician) how should we bill this. We charged OV (99213-24, cast removal (29705-79) and for x-rays but the computer claim check held the claim. Any suggestions?

 

[thomas7331]

You are allowed to bill for this unless it's a formal transfer of care from the surgeon. Per the Medicare Claims Processing Manual, Chapter 12: "Where a transfer of care does not occur, occasional post-discharge services of a physician other than the surgeon are reported by the appropriate evaluation and management code. No modifiers are necessary on the claim."

 

[mk2001]

We have a patient who was out of state and fractured his right wrist and had fracture care in that state. During the 90 day global he comes into our office for a problem with his leg/ankle. While here we did remove the cast on the wrist. Since this is during the global for the fracture care (although my doctor was not the treating physician) how should we bill this. We charged OV (99213-24, cast removal (29705-79) and for x-rays but the computer claim check held the claim. Any suggestions?

Was the patient in a global period for a surgery from your provider? If not, I think the 24 modifier should have been a 25.