Our general surgeon recently employed a nurse practitioner in the office. The nurse practitioner is seeing patients on rounds in the hospital, and she recently submitted a charge for a 99232 on a Medicare patient who was post-op total thyroidectomy. The documentation for the visit all pertained to the thyroidecotmy. Can she report this E&M service when the patient is in a global period? She says yes, because she did not assist and is not in a global period.
Answer:
Great question and one of increasing concern as it relates to one of many issues related to Non-Physician Provider billing. We appreciate your attentiveness and raising the question. While the nurse practitioner was not involved in the surgery, she is employed by the surgeon who performed the surgery; thus all visits related to the surgical procedure are included in the global period, and not reportable whether performed by the surgeon or the nurse practitioner. If the visit was for an unrelated problem that was evaluated and managed, the service would be reportable by the surgeon or the nurse practitioner, and a modifier 24 would be appended to the E&M and the appropriate unrelated diagnosis linked to the E&M.
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