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Thread: Not billing a procedure that will have a 90 day global

  1. #1

    Default Not billing a procedure that will have a 90 day global

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    If the doctor decides not to bill a one procedure out of 5 done at time of surgery because that one has a 90 day global and then can't charge for an E/M following surgery,,is that legal? And what if the surgeon doesn,t bill but the hospital does?

  2. #2
    Join Date
    Apr 2007
    Location
    San Diego
    Posts
    163

    Default

    Hi,

    I don't think that this is "allowed". I believe that all procedures must be submitted to payors, especially if the patient is Medicare (Mandatory Claim Sumission). If the procedure carries a 90-day global, then it's probably a high dollar service. Would the physician rather lose out on the revenue generated by this service to cover post-op/routine care? It doesn't seem logical.

    Just my two-cents worth...

    Good Luck!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

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