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Wiki Global period billing

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gski

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Sheridan, MI
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Per Administration/Management at my employer: "The advice from the McGladrey Consultants is to bill for everything we do regardless of the global period. We may not be paid but we are required to report/charge for everything we do even if it is within global period."

I disagree with this, and believe a 99024 should be applied to the patient's account with a $0 charge for tracking purposes for services we know are included in the postop global period.

Does anyone have a LCD or link that will dispute this? I disagree with this billing guideance from our administrators, and would greatly appreciate any supporting documentation that you can point me to!! Thank you!!
 
gski said:
Per Administration/Management at my employer: "The advice from the McGladrey Consultants is to bill for everything we do regardless of the global period. We may not be paid but we are required to report/charge for everything we do even if it is within global period."

I disagree with this, and believe a 99024 should be applied to the patient's account with a $0 charge for tracking purposes for services we know are included in the postop global period.

Does anyone have a LCD or link that will dispute this? I disagree with this billing guideance from our administrators, and would greatly appreciate any supporting documentation that you can point me to!! Thank you!!
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Your best guidance comes from our book. If you look carefully in the CPT book, there are Guidelines for use of the codes. At the beginning of the Surgery section there is a definition for the Surgical Package. Certain procedure codes will have guidelines written around them. The other document that has a lot of guidance in it is the Medicare Claims Processing Manual Chapter 12 section 40 has a very long description of global surgery package.

Certainly you can "track" every encounter with a patient, but according to proper billing guidelines you do not "bill" every encounter. They need to know that billing for services that are included can be considered fraudulent. It iwll most certainly trigger an audit.
 
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