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E/M during post op

  1. #1
    Default E/M during post op
    Clearnace Sale

    I need a little help. We have a patient that is 5 days post op SCS implant. The patient reports improvement in pain levels and no new complaints. There are no new medications ordered just refill on previous medications.

    The provider feels that he should be able to bill because patient is receiving medication refills.

    He wants to know how he is to get paid for patients with peripheral lead implants that have a 90 day global. Same scenario, no new complaints, no new medications.

    thank you in advance,

  2. #2
    Milwaukee WI
    Default Who did the surgery?
    Who placed the implant? If it your physician, then the 90-day global covers all the postoperative care. NO charge for the visits. Your physician is already being paid for this service - it is part of the reimbursement for the surgery.

    If it was a different physician ... either different practice or different specialty in the same practice ... then you are not covered by the post-op period and can bill appropriately documented E/M services as per usual.

    F Tessa Bartels, CPC, CEMC

  3. #3
    This is a pain management group and we did the SCS implant. The providers are insisting that they should get paid as they normally do for medication management whether it is post op or not.

    Provider says it is not post op because he didn't see the patient for anything having to do with the procedure. He is managing the patients medication as he normally would do on a monthly basis.

  4. #4
    The procedure was for pain management, the presriptions are for pain management, therefore the prescriptions and the procedure ARE related, and they will not get paid for the office visits within the 90 day global period.
    Walker Bachman, CPC, CPPM

  5. #5
    thank you! This will give the docs something else to think about.

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