Wiki EP Global package - HELP

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cvand1972

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A patient comes in for a site check. I know that's included in the global package, but during that site check, they also do a pacemaker interrogation, which I know is not included because the guidelines state that testing and procedures are not included in the global package. My new EP Docs are ganging up on me telling me that I am wrong. They are telling me that they are included.
Oh, and I want to add that we are getting paid for them after we bill them (otherwise most insurances will deny for being part of the global package...well, at least Medicare would).
Can I get any other EP office words of advice???
 
Look at your Medicare LCD, ours, Trailblazer lists the frequency limits, and I believe it states you can bill one in the global period.
 
I couldn't find it. One of the Docs asked me to call Boston Scientific's reimbursement specialists because he didn't believe me. I did what he asked and she said the same thing. You CAN bill an interrogation because it is considered a Diagnostic Test/Procedure, therefore not covered under the surgical global package. I try to stay away from that but sometimes the reimbursement specialists are pretty helpful. According to the EP Nurse, you can't. I think I'm going to have a harder time convincing her.
 
You are correct, ICD interrogations are not included in the global package and you can bill for it. I found a link to CMS regarding the NCD for ICD defibrillators. Boston Scientific also has a great billing and coding guide that you can order on-line. It gives alot of information on Medicare's billing guidelines. Best part...it's free!

http://www.cms.hhs.gov/mcd

click on search and enter ICD defibrillators and go to this link:

20.4 Implantable Automatic DEFIBRILLATORs

good luck!
 
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