Wiki Global Denial

[NESmith]

We have a patient that one of our Infectious Disease providers saw and did a Oasis application that has a 90 day global. In the meantime the patient was admitted to the hospital and a General surgeon did a excision of a sacral presurre wound with a rotation flap closure which also has a 90 day global. While the patient was in the hospital the patient developed a low grade fever and another one of our Infectious Disease provider was called into see the patient. Medicare is denying his services as inclusive to another service. Is it denying against the surgeon or the other Infectious Disease provider? And if it is which modifier would be appropriate or would these visits be considered a follow-up and included in the global procedure? Thanks for your help

 

[FTessaBartels]

Global denial is correct

The global period applies to the physician who performed the procedure - AND to any other physician in the same practice with the same specialty.

Your infectious Disease specialist performed a procedure with a 90-day global period. Your second ID specialist (if in the same practice as the first) is covered by the global period. Medicare will NOT pay for ANY visits related to the procedure, including subsequent hospitalization for complications.

Hope that helps.

F Tessa Bartels, CPC, CEMC