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Global Period with Different Provider/Same Practice

  1. #1
    Location
    Overland Park, KS
    Posts
    1,166
    Default Global Period with Different Provider/Same Practice
    Medical Coding Books
    I am auditing a chart and this issue has come up. For this clinic, we have two providers. Dr. A and Dr. B. A patient came in to see Dr. A for a skin tag removal. I am aware that there is a 0-10 day global period attached to this procedure. My question is, the patient came in for follow-up three days after the procedure, but they saw Dr. B instead. The providers are questioning this. Does the global still apply to Dr. B since he did not do the surgery? I say yes, but he coded this with a regular E/M and is questioning why it would be 99024 (my detemination). Can anyone help me clearly explain this? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. #2
    Location
    San Antonio, Tx
    Posts
    73
    Default
    First, does Dr. B have a subspecialty? Did Dr. B see this pt for the Tag Removal follow-up? If Dr. B has a subspecialty and did NOT see the pt for the Tag Removal, then you can bill an E&M. If he has the same specialty and the pt was seen for the tag removal F/U, then it is 99024.
    Ray Galvez CPC

  3. #3
    Smile
    I am with you. If this is a f/u from skin tag removal it is a post op.
    Colleen R Cox CPC

  4. #4
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    There is no subspecialty. Both are primary care providers and the follow-up was for the tag removal. I too thought that the global would still apply since this is the same specialty, but Dr. B states that the global period excludes services provided by other providers so the global does not apply to him. I disagree and think 99024 is appropriate. Thanks Ray and Colleen for your help.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  5. #5
    Default
    I agree, CMS sees providers of the same specialty in the same group as the same person, this would be global.

    Laura, CPC, CEMC

  6. #6
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    My thoughts exactly. Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  7. #7
    Wink
    I am my partner and my partner is me.

  8. #8
    Default
    I was reviewing your question, and you want to keep in mind that if the patient came back for just the follow-up, then yes it will be global, but if the patient has a complication, ex: reaction to prescription, then use a modifier 24 on the E/M and it will get paid. Just make sure that it has a different diag than the initial procedural visit. ex: complication code...
    Kristen Richard, CPC

  9. #9
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by krssy70 View Post
    I was reviewing your question, and you want to keep in mind that if the patient came back for just the follow-up, then yes it will be global, but if the patient has a complication, ex: reaction to prescription, then use a modifier 24 on the E/M and it will get paid. Just make sure that it has a different diag than the initial procedural visit. ex: complication code...
    Not for Medicare...(complication)

    Many carriers follow CMS's global policy...you would need to check your payer to see if the follow CMS' global policy or CPT's

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