Assist Surgeon and post op care

Does the Assist Surgeon fall under the global surgical package also or are they able to bill for post op care given to the pt, even if the pt is an established pt with them?

assist

The assistant at surgery does not fall under global rule. If there is a transfer of care for post-op care, the assist must bill the surgery code and date of surgery with modifier 55, after the first post-op office visit. The surgeon must use surgery code with modifier 54

Assist Surgeon and post op care

This was not a transfer of care. The assist surgeon billed with the 80 modifier for the surgery and provided all the post op care for the pt directly after surgery to hospital discharge and follow up in the office for staple removal and wound check. Would the assist surgeon be able to bill for all of these visit? Should he use the 55 modifier?

surgery

The surgeon is responsible for surgery code - 54, which includes hospital visits. If the assist provided all post-op care aftyer discharge, he bills with the surgery code and modifier -55 and date of surgery.
Splitting Post Operative Care

Specific billing guidelines must be followed when the surgical procedure and the post operative care is split between different physicians.

Modifiers 54 and 55 are used to indicate that the surgical care and post operative management services are being rendered by two different physicians. The physician who is rendering the one-day preoperative care, the intraoperative services, and any in-hospital visits bills his/her services with the date of the surgery, the procedure code for the surgery, and a 54 modifier to indicate that the bill is reflective only of the surgical care.

The physician rendering the postoperative, out of hospital care associated with a given surgical procedure should bill for his/her services with the date of the surgery, the procedure code for the surgery, and a 55 modifier. If the surgeon also cares for the patient for some period following discharge, the surgeon should bill the surgery with a 55 modifier and indicate the portion of the post-op care provided in addition to the surgery with a 54 modifier. (to
indicate the intra-operative service)

In those cases where the postoperative care is "split" between physicians, the billing for the postoperative care should be reported as follows:

?Report the date of service using the date of the surgical procedure.
?Report the procedure code for the surgical procedure, followed by modifier55.
?Report the range of dates that you provided the postoperative care in the procedure description (narrative) field on electronic claims, and block 19 on the CMS-1500 claim form. We do not need each date; only the range of dates.
?Both the surgeon and the physician(s) providing the post-operative care must keep a copy of the written transfer agreement in the beneficiary's medical records.
?Where physicians agree on the transfer of care during the global period, the following modifiers are used:
• “-54” for surgical care only; or
• “-55” for postoperative management only.

Both the bill for the surgical care only and the bill for the postoperative care only, will contain the same date of service and the same surgical procedure code, with the services distinguished by the use of the appropriate modifier.

Providers need not specify on the claim that care has been transferred. However, the date on which care was relinquished or assumed, as applicable, must be shown on the claim. This should be indicated in the remarks field/free text segment on the claim form/format.

Both the surgeon and the physician providing the postoperative care must keep a copy of the written transfer agreement in the beneficiary’s medical record.

?Where a transfer of postoperative care occurs, the receiving physician cannot bill for any part of the global services until he/she has provided at least one service. Once the physician has seen the patient, that physician may bill for the period beginning with the date on which he/she assumes care of the patient.

assistant surgeon

Is the assistant in the same practice?

I don't think any of these are reimbursable without a transfer of care. The surgeon was paid for the global service, and if the assistant provided the care, they are due some of the money from the surgeon, not the payer. (Not that I think you'll collect it from the surgeon.....)