Wiki Global period

[tfischer]

When a physician OUTSIDE of our group does surgery on a patient that has a 90 day global period, and a PHYSICIAN within our group is on call for the weekend and rounding on the same patient. How are we supposed to be billing for this service? The encounter is only for follow up after surgery, and the patient is not having any other problems.

Previously, we were billing for this. BUT I am starting to look at it from a patient's standpoint...if I'm having surgery and it's supposed to have a 90 global period, then why am I being billed for this service another physician provided? I never chose that physician.


HELP!! Please!

 

[FTessaBartels]

Truly covering for the other physician?

If you are truly "covering" for the other physician then I would think you would assume his/her global periods. This may be a case where the opposite sometimes happens -- i.e. your surgeon is off on the weekend and that OTHER physician covers the routine post-op care visits. There should be some agreement between the practices with respect to how to handles these cases. For record keeping purposes, you might want to set up a dummy code to track these visits in your system, but no bill would go to insurance or the patient.

I may not be fully understanding your scenario, and if I'm wrong, I apologize.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[Grintwig]

In our practice our docs do the same for another local surgeon. Unfortunately I never know what the patient is being seen for other than the diagnosis. I do not know if they have had a surgery or not so I code a hospital follow-up day and if we get denied for global reasons we then write off the charge. That way the fact that we did see the patient is documented but they do not get a bill for the visit if it was covered under a surgical global.