Wiki Global billing and ER visit

[JDuhaime]

Patient is in global for hip fx goes to ER for anemia and next day has a consult by another provider in the ortho office for hip and thigh pain. Would it still fall into post op?

 

[csperoni]

It mainly depends on the reason for the hip and thigh pain.
If the additional visit is treatment of the underlying condition or an additional treatment that is not part of surgery recovery, then the service is not included in global. If (seems unlikely, but possible) the pain is unrelated to the fracture, then not included in global.
If the visit is for postoperative pain management, then it is included in global.
The CMS Global Surgery booklet is a great resource. I've even used it to dispute audit findings.

https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/globallsurgery-icn907166.pdf