The care provided by the cardiologists is part of the global surgical package. If the patient was in the ICU for an unrelated problem, then that would be billable.
Excerpts from the
Medicare Global Surgery booklet:
Is the global surgery payment restricted to hospital inpatient settings?
Global surgery applies in any setting, including an inpatient hospital, outpatient hospital, Ambulatory Surgical Center (ASC), and physician’s office. When a surgeon visits a patient in an intensive care or critical care unit, Medicare includes these visits in the global surgical package.
Outside the global surgical package: Critical care services (CPT codes 99291 and 99292) unrelated to the surgery where a seriously injured or burned patient is critically ill and requires constant attendance of the physician.
Critical Care
Critical care services furnished during a global surgical period for a seriously injured or burned patient are not considered related to a surgical procedure and may be paid separately under the following circumstances.
Pre-operative and post-operative critical care may be paid in addition to a global fee if:
• The patient is critically ill and requires the constant attendance of the physician; and
• The critical care is above and beyond, and, in most instances, unrelated to the specific anatomic injury or general surgical procedure performed
Such patients are potentially unstable or have conditions that could pose a significant threat to life or risk of prolonged impairment.
In order for these services to be paid, two reporting requirements must be met:
• CPT codes 99291/99292 and modifier “-25” for pre-operative care or “-24” for post-operative care must be used; and
• Documentation that the critical care was unrelated to the specific anatomic injury or general surgical procedure performed must be submitted. An ICD-10 code for a disease or separate injury which clearly indicates that the critical care was unrelated to the surgery is acceptable documentation.