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Wiki Bill E/m visit for preop during global

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flipden5

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Good afternoon, we have a patient that had a tissue expander inserted, then had it removed during global due to inflamatory issue and is going to have another one inserted 2 months later but still in the global of both procedures. Can the surgeon bill an E/M visit to make sure everything is ok prior to the next surgery? thank you
 
"To make sure everything is OK" is a little to vague to definitively state either way. If the physician already made the decision for the surgery, and the patient is coming in just to go over instructions again, then I would consider this part of the global package. If the physician is evaluating the situation, and is deciding what surgery should be performed at this time, it may be billable outside global. Please note that Medicare has a more strict definition of the global surgical package than AMA does. Depending on which guidance the payor follows, it may be billable.
Here is Medicare's global surgery reference: https://www.cms.gov/files/document/mln907166-global-surgery-booklet.pdf
 
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