Wiki Global Surgery

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becca12

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Hello,

I work for a small practice in a rual area and we send our orthro patients to the bigger city to have surgery. We just seen one of our patients for knee pain a week after his total knee replacement. I was wondering if there was any modifer I can put on the claim to get our services paid? Or if we have to eat the costs. I contacted the surgeon and he is billing the global for the total knee.

Thanks

Rebecca
 
If your doctor did the pre-op and the post-op work he should append modifiers 55 and 56 to the respective services.

If the surgeon did only the surgical care he should not be billing globally and should use the 54 modifier.

Hope this helps

Tina
 
I thought that you could only use those if the surgeon wasn't going to bill the gobal for the surgery. I am just trying to get it straight in my mind.

Thanks

Rebecca
 
You are correct..........but from your first post it sounds like your physician did the pre and post op work if so it is appropriate to code those modifiers. If the surgeon did NOT do the pre or post op work then I would talk with their offiice manager because they should NOT bill the global if they did not do the work.

Hope this helps
Tina
 
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