Wiki global period question

[AmandaW]

If patient is in the global period for cataract surgery but is coming in to her eye Dr's office (Dr is different from surgeon) for a different eye problem-will that be able to be separately billable? Is there a modifier?

Thank you for your help!

 

[Chelle-Lynn]

A modifier is only required when the patient is seen by the same provider as the surgeon during the post-operative for an unrelated reason. In this case the provider and reason for service are different, so no modifier is required.

 

[mcpalmeter]

If patient is in the global period for cataract surgery but is coming in to her eye Dr's office (Dr is different from surgeon) for a different eye problem-will that be able to be separately billable? Is there a modifier?

Thank you for your help!

If the doctor's are in the same group then they would usually be considered the same doctor. However, if the visit is UNRELATED to the surgery but falls within the global period for the surgery, append modifier 24 to the visit/eye exam code.

Example: Cataract Surgery performed on Right Eye
Visit during global period to assess cataract in Left Eye
or Visit during global period to assess and treat glaucoma in Right Eye

 

[AmandaW]

Thank you for your responses.


MaryAnn, the only thing about the 24 though is that it says services by the same physician (??)

 

[Cheezum51]

As long as the eye doctor seeing the patient for a non cataract surgery problem isn't in the same group and isn't providing post op care for the cataract surgery, there shouldn't be a need to use a modifier.

Tom Cheezum, O.D., CPC