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 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 just 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 99213 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?
The surgeon returns to his practice in Juneau and the patient's primary care physician provides 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 just 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 99213 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?