rlohearn
Contributor
I appreciate advice, help, thoughts, etc. on this challenging situation:
Surgeon A performs exploratory laparotomy, encounters extensive radiation enteritis, proceeds to colectomy, etc. Patient sent to wound care center for the radiation enteritis and also nonhealing abdominal wound, where Physician A evaluates patient, recommends hyperbaric therapy, and proceeds with daily HBOT. Surgeon B (same specialty & group as Surgeon A) sees patient in wound care center too, usually on same day as Physician A is performing HBOT supervision. (All three use the same TIN, by the way.)
Physician A's follow-up notes are generally geared more toward HBOT assessment (initial note included wound evaluation, though), while Surgeon B's notes are mostly inspection of wound, "ok to proceed with HBOT". Seems duplicative to me, but the question is.....
Does Surgeon B have a billable E&M service, given that patient is in global (due to surgery performed by his same-specialty colleague) but has complications that *could* be considered separate from global, and patient is already being seen same day by Physician A in HBOT for essentially the same issue? On the one hand, we have complications that are separately billable in the global period; but on the other hand, I'm not getting the necessity of an E&M for Surgeon B's evaluation of wound when the patient's being followed by Physician A in HBOT for it.
Thanks in advance for your help!
Surgeon A performs exploratory laparotomy, encounters extensive radiation enteritis, proceeds to colectomy, etc. Patient sent to wound care center for the radiation enteritis and also nonhealing abdominal wound, where Physician A evaluates patient, recommends hyperbaric therapy, and proceeds with daily HBOT. Surgeon B (same specialty & group as Surgeon A) sees patient in wound care center too, usually on same day as Physician A is performing HBOT supervision. (All three use the same TIN, by the way.)
Physician A's follow-up notes are generally geared more toward HBOT assessment (initial note included wound evaluation, though), while Surgeon B's notes are mostly inspection of wound, "ok to proceed with HBOT". Seems duplicative to me, but the question is.....
Does Surgeon B have a billable E&M service, given that patient is in global (due to surgery performed by his same-specialty colleague) but has complications that *could* be considered separate from global, and patient is already being seen same day by Physician A in HBOT for essentially the same issue? On the one hand, we have complications that are separately billable in the global period; but on the other hand, I'm not getting the necessity of an E&M for Surgeon B's evaluation of wound when the patient's being followed by Physician A in HBOT for it.
Thanks in advance for your help!