Wiki E&M during Global period by surgeon

[AR2728]

Here's the scenario:

General surgeon admits a patient for appy and incarcerated umbilical hernia, performs appy on ruptured appendix as well as the hernia repair. Patient is Inpatient for a total of 15 days following surgery. Patient has other unrelated issues, develops pneumonia, etc. My problem, the surgeon wants to bill a subsequent hospital follow up for each day following the surgery due to the patients multiple issues, HOWEVER, the surgeon has requested the hospitalist consult on the patient on day 2 and the hospitalist is now following the patient for his multiple medical issues. It is my understanding, that the surgeon can not bill a subsequent hospital care visit, since the Hospitalist is actually following and treating this patient for his multiple other issues even though the surgeons dictation lists EVERY issue this patient has. Am I correct?

 

[LindaEV]

You are correct. The surgeon cannot bill for any post op care during the global period. For medicare, he cannot bill anything unless it is a return to the OR. Some commercial payers will pay for treatment of non-OR, but extreme (abnormal) complications.

 

[AR2728]

Thanks for the quick response. Sometimes, I find I need a little reassurance.