Wiki Global post op periods

Create Wiki Sort by date
F

Flipzdaisy

Guest
Messages
2
Location
Albany, OR
Best answers
0
I have a question, if a patient has had a procedure from a provider outside of our clinic and is not a partner in our clinic,does the 10 day, 90 day global period apply? We are an out patient hospital wound care and see patients after surgery for complications such as infection, no healing wounds, wound vac care, ect. We provide wound care and debridement's cpt code 11042-11047. Are we able to bill for this care because it is a complication from the said procedure, operation while it is still in global if the surgeon doesn't formally hand over care, and sends us a referral to see this patient for their wound care? Any clarity would be most welcome. Thank you in advance
 
1
davidgraymilliman said:
Global periods are attached to the procedure, not the provider performing it. Just be sure to use the appropriate modifier to explain that the procedures you're billing for are return trips to the OR for a related procedure during the post-op period (Modifier 78). This modifier doesn't start a new post-op period but does explain why you're billing for something during the post-op period of another procedure that is related to the one you're billing for now.
Click to expand...

I disagree. The definition of modifier 78 is a return to the OR "by the same physician" following the original procedure. If your physician is from a different practice, you do not need to add a global period modifier. Per CMS guidelines for the global surgical package, "services of other physician related to the surgery, except where the surgeon and the other physician(s) agree on the transfer of care" are NOT included in the global surgery payment. Since the patient in the example above is being referred from an outside provider for wound care, the global period does not apply and a modifier 78 is not required.

The following reference from Medicare may be useful:
 
0
Global periods are attached to the procedure, not the provider performing it. Just be sure to use the appropriate modifier to explain that the procedures you're billing for are return trips to the OR for a related procedure during the post-op period (Modifier 78). This modifier doesn't start a new post-op period but does explain why you're billing for something during the post-op period of another procedure that is related to the one you're billing for now.
 
You must log in or register to reply here.
Top