Global Period

NLS1983

Networker
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Location
Temperance, Michigan
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Can someone help me find some information on Glabol Periods? Our PA's are doing H&P's and we need to find out if these are billable under the global period.
 

aaron.lucas

Expert
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286
Location
Cherry Hill, NJ
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the global package guidelines at the beginning of the surgery section of CPT should have all you need. they state that "typical post op follow up care" is included in the global package, and I always consider any E/M to be just that, when it's during the global period. of course if the visit is unrelated and you have documentation to support modifier -24, then that doesn't apply. hope this helps! :)
 

Lujanwj

Guru
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The first link below will take you to Medicare Fee Schedule Data Base. Download the zip file. The .XLSX file will have the global information. I'd start out with the RUVPUF12 file first. That file will explain how to read the data in the XLSX file. Those files will tell you the Codes status, RVU's, Globals, ect...

https://www.cms.gov/PhysicianFeeSched/PFSRVF/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=descending&itemID=CMS1255291&intNumPerPage=10

If the link doesn't work, go to CMS.Gov and search 2012 National Physician Fee Schedule Relative Value File. Select 2012AR.

With all that said, I don't think you are looking for Global Periods but more of Global Package. I'd suggest pulling the NCCI Policy Manual. That will have the Package information.

https://www.cms.gov/NationalCorrectCodInitEd/

Good Luck!
 
Last edited:
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4,466
Location
Milwaukee WI
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Was this for a scheduled procedure?

I am assuming that the PA and the surgeon are in the same practice (i.e. the PA is working for the surgeon)

Scenario 1
Patient presents to your office and is diagnosed with a condition that requires a procedure. Procedure scheduled for 3 days later.
Patient presents to hospital for admission for procedure and PA completes H&P.

NO bill for PA's service, as that is inclusive to the procedure. The decision for surgery was made back when the patient came to the office.


Scenario 2
Patient presents to the office and is diagnosed with a condition that requires a procedure.
Patient sent directly to the hospital for admission and procedure to follow.
PA completes the H&P.

All E/M services documented on this same DOS would be added together to arrive at the appropriate level of Initial Hospital Visit. This would be billed under the PA's name and NPI.


Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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