Wiki Global Period 2 Part Question

[PKeeley]

Scenario - You have an LLC comprised of primary care and specialty providers who bill under one TAX ID number. All insurance payments are made out to the LLC, not to the individual providers, i.e., the providers reassign the benefits to the LLC.
question 1 - Patient undergoes surgery. While in the postoperative global period, the patient sees his primary care for an unrelated problem. Does the visit with the PCP require a modifier 24?

question 2 - Decision for left meniscectomy is made today for a surgery to take place mid December. Prior to the surgery, the patient sees his primary care for left knee pain. Is the visit with the PCP billable or is it part of the global period?

 

[LLovett]

Global only applies to the provider of the service that has a global period. In a group practice that does include all the providers of the same specialty. The other specialties, even though they share the same tax id, are not included.

Question 1, no you would not need a 24 because the PCP is a different speciality and should not be affected by the global period.

Question 2, the global period does not start until 24hrs prior to the procedure and again does not affect providers of different specialties. This service by the PCP is billable.

Laura, CPC, CEMC