Post Op visit by same physican after he changes practice


Shrewsbury, MA
Best answers
Our office hired a new MD recently and he billed an OV-Level 2 on a patient who followed him from a previous practice where he performed a major surgery recently.
If this surgery was done at our office, we would bill this visit as 99024 global if within 90 days.
Can MD bill OV(any level) for post op if they change practice? I couldn't find anything in writing in CMS for such a specific situation.
Any help or cms links is appreciated. Thanks


True Blue
Best answers
The global payment includes post-operative care whether the physician is at the same practice or has moved to a different practice. Though he may get payment for this visit in the new office since it's a different tax ID, if it's related to the surgery then he is being reimbursed twice because the visit was covered as part of the surgical payment, and the payer will likely discover this on audit and recover the payment at some point.

Physicians who wish to transfer post-operative care to another physician or another practice should be using the modifiers 54 and 55 on the original surgery, not billing separate E/M codes, so that the payment for the post-operative care goes to the correct place - see page 9 of the Medicare publication linked below.

Global Surgery Booklet