Some of our physicians are general surgery. Sometimes we perform all of the aspects of care during the patient’s stay such as the inital visit, the surgery with follow up care.
Sometimes, a different general surgeon from a different group performs the initial visit and surgery, and when we are on call during the week or weekends, we follow up with the patient, so I figured I would bill for this visit, knowing they are in a global for the surgery, but the patient’s surgery was not performed by us. When we bill these charges out, we are hit with the denial "Benefit for this procedure/service is included in the payment/allowance for another service/procedure that has already been adjudicated.

I have researched and researched. I can not find anything that addresses this problem. I am wondering how other practices handle this. If we see that the patient is seen by a different surgeon in a different practice and the patient had surgery with the other surgeon, do we just cut our loses? That doesn’t even seem fair. Is there another modifier that we can use? Can we use 27 modifier?

If you have input, I welcome it.

Thanks so much

Beth