Wiki Post-Op visits when a provider changes practices

[KristaK]

We have a provider who performed surgery on a patient while at their previous practice. The provider has left that practice and joined a new practice. He will see the patient during the global period for the surgery. Can the provider bill an E&M visit or would they code as a post-op visit?

 

[thomas7331]

The provider should not bill E&M for the post-operative care in the global period.

If the previous practice billed for the global fee (no modifier on the surgical code), then the payment they received includes the post-operative care - billing for additional visits would be overcharging the payer. If the previous practice anticipated the transfer of care to the new practice and billed a modifier 54 and was just paid for the intra-operative portion, then the new practice may bill for the post-operative care by billing for the surgery with a 55 modifier to collect for the post-operative portion.