Results 1 to 6 of 6

Billing for office visits while in global?

  1. Default Billing for office visits while in global?
    Medical Coding Books
    We have a urologist questioning if a patient is in a global period, if he can bill for the follow for office visits because the cancer diagnosis. For surgeries billed with a cancer code, and the office visits to be billed with the same diagnosis. It is my impression that you can not bill seperetly for this. Any advice would be great!

  2. #2
    Default
    Quote Originally Posted by ECS2418 View Post
    We have a urologist questioning if a patient is in a global period, if he can bill for the follow for office visits because the cancer diagnosis. For surgeries billed with a cancer code, and the office visits to be billed with the same diagnosis. It is my impression that you can not bill seperetly for this. Any advice would be great!
    The global period applies to services relating to the surgery, not the diagnosis. It's an important distinction to make - the doctor can technically treat the patient for a problem with the same diagnosis code as the one that prompted the surgery, but that doesn't necessarily mean that the new problem is related to the surgery.

    Any routine post-operative care relating to the surgery is included in the surgical package, but evaluating and treating for complications (including a recurrance of the original problem) is not, and those visits can be reported separately.

    What you should look at, is whether this is a new problem, a complication of surgery, or side effects of treatment. Your doctor may be trying to use the wrong diagnosis code to describe the circumstance (see: ICD-9 guidelines for using aftercare codes). Hope that helps!

  3. Default
    Here is the specific problem were having. We have a patient who had an orchiectomy done and is in his 90 global period, the doctor is seeing him for an office visit to inform him that pathology came back as cancer. Can he bill for the office visit even though the patient is in a global period? Thank you for your help!

  4. Default
    Quote Originally Posted by ECS2418 View Post
    Here is the specific problem were having. We have a patient who had an orchiectomy done and is in his 90 global period, the doctor is seeing him for an office visit to inform him that pathology came back as cancer. Can he bill for the office visit even though the patient is in a global period? Thank you for your help!
    No he cannot bill for that. Discussion of path is included in the surgery.

  5. #5
    Default
    Quote Originally Posted by eadun2000 View Post
    No he cannot bill for that. Discussion of path is included in the surgery.
    Taking a sample for path is included in the biopsy/surgery - discussing the results isn't. The cancer is technically a "new" problem, since it's never been diagnosed before. The provider would have to determine a plan of treatment , and educate the patient on their condition, which constitutes MDM. This would be coded with the cancer diagnosis, not the signs/symptoms that led to the biopsy.

  6. #6
    Default
    Quote Originally Posted by btadlock1 View Post
    Taking a sample for path is included in the biopsy/surgery - discussing the results isn't. The cancer is technically a "new" problem, since it's never been diagnosed before. The provider would have to determine a plan of treatment , and educate the patient on their condition, which constitutes MDM. This would be coded with the cancer diagnosis, not the signs/symptoms that led to the biopsy.
    I could not have said it better nor with fewer words!
    Mickie Kummer, CPC, CPMA, CRC, CPC-I, AAPC Fellow

Similar Threads

  1. Billing post op visits during global
    By brittany1356 in forum E/M
    Replies: 1
    Last Post: 11-26-2018, 02:25 PM
  2. Billing for office visits while in global?
    By l1ttle_0ne in forum E/M
    Replies: 2
    Last Post: 01-21-2011, 09:22 PM
  3. Replies: 2
    Last Post: 09-15-2010, 01:57 PM
  4. Billing office visits in CA for RN
    By akinsley in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 07-08-2010, 04:11 PM
  5. Question about OB visits and global billing!
    By Stephanie39 in forum OB/GYN
    Replies: 4
    Last Post: 09-14-2009, 12:46 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?

Login

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.