Wiki Global Period Surgery

[ehearns]

Topic:
E&M serivces during global period.

Question:
Can the same provider bill for E&M 99231-99235 codes when seeing hospital based clients during the global period days - '010 ' and '090'??? Does this apply to any other codes?

Your thoughts are truly appreciated. Much Thanks.

Eddie Hearns, CPC

 

[kevbshields]

Eddie:

I'll try to make this concise.

Typically the surgery provider (who's billing for the surgery service) would not charge for follow-up in the hospital/office. (See CPT Surgery Guidelines.)

The exception is if/when the patient develops an unrelated co-morbility/complication, etc (Mod-24 may be assigned); It is sometimes possible that the surgery service will "sign off" on the patient, perhaps doing very random follow-up during a lengthy stay. Another service (Medicine, for example) may follow/manage the patient. If a consultation or follow-up is requested--and you can justify how the condition, presentation or service is unrelated to that surgical care--you may be able to pick up those services with the E/M codes.

As for other procedures/services, most should be "codeable". For instance, if the surgeon subsequently must perform bedside wound debridement for a complicated wound healing, those services could be correctly assigned. As for payment of those services, that may be a problem area. Be sure you're using modifiers on anything that could be considered incident to or "routine" post-operative care.

I hope this helps some.

Good luck to you. If I haven't touched on your specific, you can private message me and I'll do my best.

 

[ehearns]

appreciation

Thank you.

Eddie