BC Advantage - 2012 Issue 11

When Is a Decision Reimbursable?

Many commercial carriers have providers in an uproar regarding the carrier's interpretation of the global surgical package. Here is the scenario:Patient presents to the Emergency Room for evaluation, and after evaluating the patient, the ER provider determines that the patient's condition warrants an evaluation by a surgeon. The surgeon comes to the ER, evaluates the patient, and makes a decision for surgery. The patient is immediately taken to the OR for surgical intervention.When reimbursing this service, many carriers are not allowing two (2) E&M visits on the same date of service and therefore are bundling the surgeon's...

To read the full article, sign in and subscribe to BC Advantage.

Access to this feature is available in the following products:
  • BC Advantage, 30+ CEUs & Webinars

free demo
request yours today
for any budget
sign IN
welcome back!