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Post op other physician

Maurice Posted Wed 13th of March, 2013 19:40:38 PM

When the on-call physician sees a patient and decides to take the patient to surgery, is the visit and surgery billable when another physician has done the previous surgery and the patient is still in the global period? The physicians are from different clinics, different tax id.

SuperCoder Answered Thu 14th of March, 2013 13:45:34 PM

Physicians Who Furnish Part of a Global Surgical Package

More than one physician may furnish services included in the global surgical package. It may be the case that the physician who performs the surgical procedure does not furnish the follow-up care. Payment for the post-operative, post-discharge care is split among two or more physicians where the physicians agree on the transfer of care. When more than one physician furnishes services that are included in the global surgical package, the sum of the amount approved for all physicians may not exceed what would have been paid if a single physician provided all services, except where stated policies allow for higher payment. For instance, when the surgeon furnishes only the surgery and a physician other than the surgeon furnishes pre-operative and post-operative inpatient care, resulting in a combined payment that is higher than the global allowed amount.

The surgeon and the physician furnishing the postoperative care must keep a copy of the written transfer
agreement in the beneficiary’s medical record. Where a transfer of care does not occur, the services of
another physician may either be paid separately or denied for medical necessity reasons, depending on the
circumstances of the case.Split global-care billing does not apply to procedure codes with a zero day post-operative period.For more information, refer to the “Medicare Claims
Processing Manual” (Chapter 12, Sections 40.1, 40.2,
and 40.4 - Physicians/Nonphysician Practitioners)
available at http://www.cms.gov/manuals/downloads/
clm104c12.pdf on the CMS website.

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