September 4, 2014
One of our surgeons saw a patient in the office and did a surgical excision of a lesion and placed sutures. Our on-call surgeon was called to the ER later in the evening to see the patient who presented with bleeding at the site of the excision. The on-call surgeon placed a suture to control the bleeding. We follow Medicare rules for all services in the global period, but are unsure if this is billable or not because the patient returned to the ER and not our office and was seen by a different surgeon in our group.
Thanks for your inquiry and the specifics of your question. In this scenario, the control of the bleeding, though by a different surgeon in the same group, is performed in the ER, and is considered inclusive to the excision during the global period according to the Medicare definition of the surgical package. It is considered a “complication” and did not require a return to an approved operative suite for surgical management. The services by the on-call surgeon are not separately reportable.