Wiki Opinions on visits during global period

[AR2728]

I'm requesting feedback on whether days 4/16 and 4/17 should fall within global period-I feel they should. Here's my example:

4/15: Patient admited to inpatient with appy symptoms-developed a rash due to CT contrast and noted on H&P solu-medrol and benadryl was given and rash appears improved

4/15: appy performed

4/16: post op visit surgeon wanting to bill Sub Inpt level because he mentions rash as faded and resolved will monitor(while also listing the myriad of other issues-dehydration/hypokal/hyponat-that were present on admission and related to appendicitis)

4/17: post op visit-surgeon wanting to again bill Sub Inpt because he mentions elevated glucose likely related to solu-medrol glucose reading now 94 and stable

I do not feel like these are enough to warrant E&Ms as unrealted to the global package. The rash was already clearly resolving on the same day and follow up visits would not have been necessary for this issue alone, no additional treatment was provided. Likewise, with the mention of glucose. I appreciate any and all feedback.
This is a very difficult provider who tends to choose an E&M during most global periods, frequently mentioning chronic GI conditions or resolved issues regardless of the patient presenting complaints.

 

[ccardella]

I think they do warrant e/m in global. For a diffuse rash a follow up would be medically necessary so an e/m is appropriate and it is unrelated because it is due to CTcontrast not appendicitis(a low-level problem focused). Same with the elevated glucose as it is unrelated to the appendicitis it is due to possible the solu-medrol(low-level problem focused).

 

[AR2728]

Thanks. I think I tend to be too judgemental where this provider is concerned and needed a fresh perspective.