Forum - Questions & Answers

Jun 23rd, 2011 - virginiaziegler

Global Surgery Rules

I have an insurance that has denied the charges for emergency reduction of tibial plateau stress fx for authorization. they have been denying the charges for the followup visits. Since they did not pay the surgery charges can they bundle the follow up visits?

Jun 23rd, 2011 - DebraS   67 

re: Global Surgery Rules

I guess I read out of order. If it were a true emergency then usually only a notification is required and if you have enough documentation on the "emergency" you can easily appeal it. #2) On the f/u visits, actually I've not had this experience before but you can try filing an E/M if you're going to just w/o the surgery since it was not actually approved and if they deny, then you'll only have your non-global package services you can bill out (eg, xrays, etc). #3) What POS (ER, office)? I'm sure someone might have had this experience before. Have you called the carrier and just asked them? It's a little difficult not knowing all the circumstances. Sorry, wish I could be more helpful. I'm more curious on the appeal that was done.



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