Wiki Subsequent Visits

[penswhitex]

I have a question regarding consults and subsequent visits pertaining to a cardiovascular surgeon. He is new to the group and we are new to his billing. If he sees a patient as a consult (commercial ins) on Monday, is going to do a CABG on Friday and follows the patient Tue, Wed, and Thursday, are any of these visits, other than the consult, billable? Thanks in advance for the help.

 

[mshaw530]

I am in the exact same boat, where I just started coding for a CTS and had this same question. The way it was told to me is that if the decision to have the CABG was made during that consult (on Monday) and pt/Dr. is just waiting for an OR on Friday, then the subsequent days are NOT billable. But if there are tests being ordered/performed on those subsequent days that are needed in order to determine whether surgery will be done, then yes, they are billable.
Like I said, I'm new to this also and this is how it was explained to me. I would be interested to see what others have to say also

 

[j.monday7814]

yes, the decision to perform the surgery is the crucial point. But remember the global period is only one day previous to surgery, so the subsequent visits on Tues and Wed are outside the global period and as long as they meet all requirements then they are separately billable. The visit on Thurs would not be billable since it is within the global period and the decision had already been made.