decisionhealth Newsletters, Part B News - 2017 Issue 12 (December)
For post-op on someone else’s surgery, bill for service – but not for E/M
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Article Overview
This article explains a post-operative billing scenario involving care provided by a local practice after surgery performed in another location. It covers general Medicare-related guidance, the use of surgical and post-operative care modifiers, and how billing may differ for office visits versus imaging services during the global period. The discussion is relevant to coders, billing staff, and clinicians who handle global surgery claims and cross-location follow-up care.
Why This Topic Matters
Understanding how post-operative care is billed when surgery and follow-up occur in different locations helps practices avoid improper claims and recognize when a service may or may not be separately reportable.
What You Will Learn
- How global period billing can be affected when surgery and follow-up care occur in different places.
- The role of written handoff and post-operative responsibility in claim processing.
- General considerations for billing imaging and evaluation services in a post-operative setting.
- Questions that may arise when appealing denials for post-operative services.
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physicians
- Physician assistants
Modifiers Discussed
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