AAPC - Back to school
Results 1 to 6 of 6

Thread: Billing post-operative care

  1. #1
    Join Date
    Apr 2007

    Default Billing post-operative care

    AAPC: Back to School
    Hi. We have a situation that came up in our office that we are unsure on how to code. We have an orthopedic physican who comes to our facility 5 days per month. He is contracted through our clinic, and we do the coding and billing for anything he does while here. He is not a locum. He also practices in another town near here and does a lot of his surgeries there. The problem we are running into is, can we bill post-operative care when it is done in our facility, when the surgery was performed in another town, but by the same physician? Would we want to append the modifier -55 to this? Any suggestions would be appreciated!

  2. #2


    I would think that since the same provider performed the surgery is also doing the follow-up, it would be global regardless of where he sees the patient.


  3. #3
    Join Date
    Apr 2007


    I agree, it doesnt matter what town he sees them in, its still post op 99024

  4. #4

    Question Cite Proof?

    Can anyone cite any "proof" of how to do this? I have been researching for a smiliar situation, and I can't find anything.

  5. #5
    Join Date
    Apr 2007
    Nashville AAPC Chapter


    Same physician/surgeon, same Tax ID#, regardless of where he sees the patient - it is global.

    Authorative Source:
    Medicare Global Surgery Fact Sheet

  6. #6
    Join Date
    Apr 2007
    Upland, PA

    Talking Bill for Post Op Care?

    If the patient is in a global period for a surgical procedure that the Physician performed, what billable service would the patient be receiving? If the modifier 55 is appended, the surgery billing would need to include a 54, and reimbursement would be reduced.

    I am sorry, but perhaps I am not understanding the situation. From your post:
    "The problem we are running into is, can we bill post-operative care when it is done in our facility, when the surgery was performed in another town, but by the same physician?"

    If the surgeon performs a procedure in a facility that is yours, as an employee of yours, why would/should there be any additional reimbursement due to the clinic? Just wondering.

    Karen Gallagher, CPC, COSC

Similar Threads

  1. post operative care
    By dmclain1974 in forum General Surgery
    Replies: 0
    Last Post: 08-05-2015, 06:23 AM
  2. Post-operative wound care
    By jazzyblues2005 in forum General Surgery
    Replies: 4
    Last Post: 10-16-2014, 11:54 AM
  3. Billing Post operative care only-sx was elsewhere
    By rjenn86 in forum Orthopaedics
    Replies: 2
    Last Post: 04-04-2014, 12:56 PM
  4. Post-operative care by the PCP
    By truerina in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-03-2013, 03:34 PM
  5. Critical Care vs. Post Operative Management
    By fwilliams in forum Emergency Department
    Replies: 1
    Last Post: 10-22-2012, 03:09 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.