Wiki E&M global following surgery

[jtb57chevy]

We are having an office debate about this situation.

Dr. Cardiologist sees a hospital patient, does an in-patient cath and determines patient needs bypass surgery. Dr CVSurgeon does surgery. Dr. Cardiologist does all follow-up inpatient care, i.e. 99232. Both Dr. Cardiologist and Dr. CVSurgeon are in practices that are owned by a parent group and bill under the same tax ID.

Questions - Is it appropriate for Dr. Cardiologist to bill the follow-care during the global period? Where is the line drawn -global package versus medically necessary care? Is management of medicines, etc (anything other than wound check) enough?

Any thoughts, documentation sources, etc., will be greatly appreciated.

 

[LLovett]

Is the CV surgeon no longer following the patient at all? If that is the case the cardiologist would bill the procedure with the modifier indicating they are doing all the post op only care, 55. The CV surgeon would report the procedure with the appropriate modifier indicating surgical care only.

If the surgeon is doing their own post op and the cardiologist is managing their own issues, ie medications, then it would be appropriate for them to bill for their services. Even though they are in the same group they should be credentialed as 2 different specialties and the global period for the CV surgeon would not affect the cardiologist.

Hope this helps,

Laura, CPC, CEMC