Hospital Admit during global period

lcole7465

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So my provider has a patient he performed a SCS implant, the patient went to Emergency Dept for pain and redness at the incision site. The patient was admitted and my provider saw her in the hospital 3 times. The first date actually falls on the last date of the global period. Will I be able to bill for this visit or will it still fall within the global period. The other 2 dates I know are billable, because they are after the global period.

Thank you
 

thomas7331

True Blue
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Per CMS guidelines, treatment for complications of a procedure is considered a part of the global surgical package, so if this admission and the services that took place during the global period were related to the procedure, then they cannot be billed. If, however, the visit involved management of problems not directly related to the procedure, then those services may be billed with a modifier 24.

Commercial payers may have policies that exclude complications from the global surgical package, but Medicare considers this global.
 
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