decisionhealth Newsletters, Coder Pink Sheets - 2006 Issue 5 (May)
Billing 2 physicians' post op care after knee surgery
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Article Overview
This article explains a billing scenario involving postoperative care after knee or hip surgery when the operating physician and a local physician both see the patient during the global surgical period. It focuses on general Medicare guidance, the possibility of shared or medically necessary co-care, and the need to check payer-specific policies. The piece is aimed at coders, billers, and physician practices that coordinate postoperative follow-up across multiple providers.
Why This Topic Matters
Postoperative global period billing can affect whether follow-up services are bundled, separately payable, or denied, especially when more than one physician is involved. Understanding the general policy framework helps practices avoid claim denials and coordinate care appropriately.
What You Will Learn
- How postoperative care is generally handled within a surgical global period
- When more than one physician may be involved in follow-up care
- Why payer policy and transfer-of-care arrangements matter
- How Medicare describes billing for medically necessary services by another physician during the postoperative period
Who Should Read This
- Medical coders
- Medical billers
- Physician office staff
- Orthopedic practices
- Primary care practices
- Specialty physicians coordinating postoperative care
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