Global Care Other Physician

[cwilson3333]

An on-call physician for emergency room, did an ORIF Femoral Shaft, CPT 27506. The patient's regular ortho doc is now taking care of the patient, subsequent care in hospital and follow up visits in office. The on-call physician did no follow-up.

I tried billing 27506-55 to Medicare for the first post operative visit, but Medicare denied, saying documentation was missing. We used the same procedure code with the modifier, and the first date my doc saw the patient in follow-up. Is this not the appropriate way to bill since my doc will be doing all the global follow-up?

Can someone shed some light on this scenario? Should I just bill fracture care CPT 27500,
amd V54.89 as diagnosis?

Need some oortho specialist advice.

Thanks,
CW

[jdemar]

The initial Dr. that billed the fx care had to have used the 54 modifier.

[cwilson3333]

Thanks.

Hopefully we can find out who bills for the on-call doctor, as he is not a local doc.

Carol