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Thread: Global ?/Different Provider

  1. #1

    Question Global ?/Different Provider

    AAPC: Back to School
    A Medicare patient is under a 90 day global for knee replacement, the patient is concerned there is a problem with the incision and comes into see a family practice physician to look at the incision, no problem is found. Does Medicare allow an EM level to a physician other than the surgeon for post-op related visits? The GP is not the same speciality, so this would be different physician/different speciality, correct? I'm not sure if I can bill for this visit. Any help, direction would be appreciated.

    Thank you in advance for your help!

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Global period

    The global period applies ONLY to the surgeon who performed the procedure (or colleagues in the same practice and same specialty).

    The patient's PCP is not subject to the global period and can bill for E/M services or procedures performed.

    HOWEVER ... the patient should have received instructions following surgery that if there were any problems with infection, pain, etc to see the surgeon immediately. The surgeon's fee for the knee replacement included such postoperative care.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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