August 24, 2017

Question:
A Medicare patient of mine presented to the Emergency Room with an infection at the surgical incision site from a surgery that I did 4 weeks ago. The surgery has a 90 day global. I was on vacation so my covering physician saw the patient and admitted her. The procedure has a ninety day global period.   Is the covering physician able to report an E/M code for this visit?  The patient did not have surgery but an I&D at the bedside.

Answer:
This visit is not considered billable by you or the covering physician  (same or different group practice) as it is  inclusive to the global surgical package.  The I&D is also not reportable as the procedure was performed in the ER and not an approved operative suite.

*This response is based on the best information available as of 08/24/17.