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Global Package

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Can someone please explain "global package" to me? I am new to surgery and would like this explained - what can or can not be billed and in what time frame? Thanks
 

mmelcam

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St. Louis, Missouri
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Shannon,

You should be able to get a list of global days from your local Medicare website. It will list all CPT codes and next to each code it will list the codes post op days. The most common ones you will see is 0, 10, or 90. What that means is that if you bill a code that has a 0 beside it then it has no post op days included in the procedure. If the patient comes back in anytime after the surgery it is billable. If the code you bill has a 10 beside it then it has a 10 day post op period. If the patient comes back in up to 10 days after the procedure, and it is for follow up to the procedure, it is included in the cost of the procedure and therefor it is not seperately billable. If they would come in 11 days or longer after the procedure then it is out of the global package and is billable. If the code you bill has a 90 beside it then it has a 90day post op period. If the patient comes in up to 90 days after the procedure, and it is for follow up to the procedure, it is included in the cost of the procedure and therefor is not seperately billable. If the patient comes in 91 days or longer after the procedure then it is out of the global package and is billable. There are some exception to these rules. Medicare will not pay for any post op complication to the procedure unless the patient is taken back to the operating room. Then it is billable with a 78. However per CPT guidelines only typical postoperative follow-up care is included in the surgical "global" package. This means that if your patient comes in with complications (infection, seroma..etc) to their procedure it would be billable with an appropriate modifier regardless of the post operative days because this is not typical post operative follow-up care. I know this sounds really confusing but once you get the hang of it, it will make sense. If you need me to explain it any further, you can send me a private message.
 
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