It is acceptable to bill as an office encounter when outside the estb global time for pre op. This not the best way as you can still face take backs in the future since technically the surgeons reimbursement includes the preoperative service. So when the payer has paid the sureon the global fee and then in tern reimburses your physician for the preop then they have paid for one part of the service twice. However having said all that, it is accepted to use just an estb patient visit level when you are outside the global.
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