Wiki E & M code for covering provider

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ladyfish11

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I need to know the code to use for a covering provider for hospital rounds. Both providers are within one group. One surgeon performed the enterectomy, which has a 90 day post op period which is a 99024 when he does hospital rounds. What E & M code would be used to report the other providers hospital rounds on that patient.
 
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If it is within the 90days you could bill the appropriate E/M code (In patient hospital , out pt office visit etc) If it is a covering Dr in the same group you add modifier Q5. If it is in the global you assign no dollar amount as the care is included. If it is outside the global window then you can charge the full amount you normally would. Each billing system is different so it would up to the office how they want the global visits billed.
 
There is no modifier required if both physicians are part of the same group and of the same specialty. According to the Medicare Claims Processing Manual 100-01, Chapter 12, subsection 30.6.5 "Physicians in a group practice who are of the same spcialty must bill and be paid as though they were a single physiican."

So you would bill as if the surgeon who performed the surgery was actually seeing the patient.
 
I agree with Doreen; if the physician that is covering rounds for the patient's surgeon is part of the same group, there should not be an E/M billed out.
 
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