Wiki Post-operative care by the PCP

truerina

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This is my auditing conundrum. A surgeon travels from Juneau to Ketchikan to provide specialized services to patients at a clinic in Ketchikan. The surgeon performs procedure code 27640 (partial removal of tibia) and 27630-51 (removal of tendon lesion) only. The surgeon returns to his practice in Juneau and the patient's primary care physician provides all the post-operative follow-up care. Neither the surgeon's nor the primary care provider's bill/documentation indicate a transfer of care. The surgeon only billed the surgery procedures and the primary care physician billed 128 days of follow-up wound care, billing CPT codes 99214 125 times and CPT code 128 3 times which appears excessive to me, however, since there is not a transfer of care agreement, the payment for these services are allowable. My question is does anyone know if there is anything in writing that suggests otherwise?

Thanks
 
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