tci Part B Insider - 2003 Issue 30

E/M Visits: Avoid 'Double-Dipping' for Post-Op E/M Visits

Global period may not apply to nonsurgeons, but ethical standards do If a surgeon hands a patient off to a nonsurgeon right after surgery, the nonsurgeon could be helping the surgeon overcharge Medicare.   When a surgeon doesn't provide any postoperative care himself, he should bill for the surgery using modifiers -54 (Surgical care only) and -56 (Preoperative management only) to indicate he only performed preoperative care and surgery, not post-op care. Then, if a nonsurgeon, such as a primary-care doctor or a cardiologist, takes over the patient, she should use the surgical code plus modifier -55 (Postoperative management...

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