Wiki Consult after emergency surgery

[MeganNicole]

I am coding for Neuroendovascular surgery. They do a lot of emergency surgeries with 0 day global, followed by the initial consult. Can I bill the consult with modifier 25 when done after the surgery?

 

[carlystur]

Well, one thing I know is you can't bill the same-day consult after the surgery was already performed on that same day, regardless of if it's a 0-day global, 10-day global, or 90-day global period because the consult did not lead to the surgery. This is because the insurance considers the cost of the doctor's visit (whether it's an initial visit or a follow-up) as inclusive to the cost of the surgery. In your case, the surgery was already decided by a different provider. For a 0-day global period, you would have to bill only follow-up appointments in the days following the surgery. You would only be able to bill both on the same day if the procedure does not have a global period.

 

[carlystur]

Does the initial consult happen on the same day as the surgery? If so, I would say that's inside the global period of the surgery, but would they be doing the consult AFTER doing the surgery? Surely, they're examining the patient BEFORE performing the surgery, right?

 

[MeganNicole]

Most NES procedures have a 0 day global. In most cases they have discussed the patient with an outside provider and are being transferred here and taken straight into emergency surgery. The provider does the initial consult on the same day, after they are out of surgery.