Wiki Global billing

[sdunaway1]

How would you code/bill for a physician that is following a different physician's patient in the hospital within the global period after a procedure ?

a) Yes you can bill the hospital visit because it is a DIFFERENT physician than the physician that performed the procedure and you can separately bill for monitoring the patient after surgery even though there is a global period. The global period only applies to the physician that performed the surgery.

b) No billing can take place because it is within the global period regardless of which physician sees the patient.

c) you should keep track and bill a 99024 as a zero charge.

I have always thought that the correct answer is b , but the neurosurgeon feels that a is correct. He frequently "follows" another surgeon's patients when it is time to be on call and we are trying to decide whether or not we can submit the billing for the E&M codes he performs for monitoring the patients after their surgical procedure.

Thank you

 

[sdunaway1]

Would this situation be considered = Transfer of Care?

 

[thomas7331]

Here's a very good reference booklet from CMS that should answer most of your questions about the global surgical package:

https://www.cms.gov/Outreach-and-Ed...oducts/downloads/GloballSurgery-ICN907166.pdf

You can see on page 5-6 what services are included or excluded from the surgical package payment. If your physician is taking over post-operative care related to recovery from the surgeon, this is included in the global package and separate charges for the postoperative visits would not be appropriate. Keep in mind that most payers consider two physicians of the same specialty and in the same practice to be the same physician. However, if they're in separate practices, the two physicians should arrange a transfer of care and bill the surgery with the 54 and 55 modifiers (see page 9). However, if you physician's services are for conditions unrelated to the surgery, or there is no transfer of care, these can be billed separately.

 

[sdunaway1]

Thank you !!!

 

[mdgiddens]

POSTOP BILLING 99024 vs established office visit

I code for a urologist, most of his procedures are 000-10 global period. When he sees the pts in the office for "postop" and documents the visit as postop. Do I bill postop 99024 or can I bill for established office visit? I was told by a colleague that because he stated in the chart it was for postop I have to bill postop. my understanding is that it's based on the Global days period you can bill an office visit per the CMS "GLOBAL SURGERY BOOKLET.

 

[mschaller]

As long as the note includes a chief complaint and enough components to meet a follow up visit you should be able to bill for it as long as it is out of the global period. Our doctors will 4 or 5 months out from surgery call it a postoperative visit but we still bill for them.