Wiki Global Surgery Package

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tmfreeman

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We were recently denied payment on a patient who came in after they had a procedure at another office and had a complication of that procedure. What is the rule on patients who have procedures at one office and then visit another office for a complication and it is during the global surgery package? Can I charge and E/M level and do I need a modifier?
 
Same practice and same specialty?

If you are in the same practice and of the same specialty as the "other office," then you are subject to the global surgical package.

If you are NOT in the same practice, or are of a different specialty than the "other office," then you are NOT subject to the global surgical package, and you should appeal with documentation and an explanation of the different practice or different specialty.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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