Patient comes in for follow-up for an ongoing problem. Surgery is recommended and the patient agrees, but doesn't want the surgery scheduled until later - as much as 2-3 months. When would the global period start? Hospital rules state the H&P/consent has to be signed and dated no more than 30 days prior to surgery. Can the MD have the patient come in prior to the actual surgery date for the H&P and consent and bill an E/M code, even though technically the decision for surgery has been made?