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If you have billed out a surgery charge with a 90 day global period, the physician cannot bill for those follow-up hospital visits unless there are extenuating circumstances that would allow a 24 modifier.
Yes, Laura has a point. While you can bill for the initial hospital visit/decision for surgery and surgery procedure/s, you will have to consider the "global period" assigned for the surgery procedure/s that was performed when billing for the post-op follow-up visits. Some surgery procedures has a 10-day, 30-day, 60-day or 90-day global period, within which you cannot bill for the post-op followup visit codes as they are considered bundled UNLESS a) the established visit you performed is unrelated to the surgery procedure that was performed (in which case you must append the E/M with modifier -24) OR b) the patient's condition required a significant and/or separate E/M above and beyond the other
service provided or beyond the usual preoperative and postoperative care
associated with the procedure that was performed (in which case you must append the E/M code with modifier -25). Bear in mind that these circumstances must be clearly documented in the medical records that you submit to the insurance. Otherwise, it may result in services denied as part of the cost of the surgical procedure.
