Global Period: What it Does (and Does Not) Include

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  • February 8, 2016
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Global Period: What it Does (and Does Not) Include

The CPT® codebook defines the following as “always included” in the global fee (global period) for a surgery or procedure:

  • Subsequent to the decision for surgery (procedure), one related E/M encounter on the date immediately prior to, or on the date of, the procedure
  • Immediate postoperative (post-procedure) care, including talking with the family and other physicians

Regarding diagnostic procedures, CPT® further specifies, “Follow-up care for diagnostic procedures includes only that care related to recovery from the diagnostic procedure itself. Care of the condition for which the diagnostic procedure was performed or of other co-existing conditions is not included” [emphasis added].

Medicare and CMS Global Period Definitions Do Not Agree

Medicare’s definition of the global package is broader than the AMA’s, but states, “Services not included in the global surgical package are as follows:

  • The initial consultation or evaluation of the problem by the surgeon to determine the need for surgery [procedure];
  • Treatment for the underlying condition or an added course of treatment, which is not part of normal recovery from surgery;
  • Diagnostic tests and procedures, including diagnostic radiological procedures
John Verhovshek
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John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

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