EHFcoding
New
Hello, we would like to ask in how other practices are reporting the preop visit for elective cases when the decision of surgery was done prior, usually within a week prior to the surgery been scheduled.
Per CMS, the global surgical package, also called global surgery, includes all necessary services normally provided by a provider (or members of the same group with the same specialty) before, during, and after a procedure. Providers in the same group practice, with the same specialty, must bill and accept payment as though they’re a single physician. Medicare payment for most surgical procedures covers both the procedure and post-operative visits occurring within a global period of 10 or 90 days following the procedure. From a CMS perspective, a visit that occurs in the interval between the decision making visit and the day of the surgery, even when it may be the preoperative history and physical, is only included in the global surgery package when it is performed on the day before or the day of the major surgery as per the designated global surgery period days (i.e. 92 days) for major surgeries. However, CPT, in their Surgery Guidelines section of the CPT manual includes the same items as CMS in their definition of the surgical package except CPT does not designate procedures as “minor” or “major” and does not assign any “global days” like CMS does for every procedure. Therefore, from a CPT reporting perspective any visit related to the surgery after decision for surgery has been made is included in the surgical package.
Thank you.
Per CMS, the global surgical package, also called global surgery, includes all necessary services normally provided by a provider (or members of the same group with the same specialty) before, during, and after a procedure. Providers in the same group practice, with the same specialty, must bill and accept payment as though they’re a single physician. Medicare payment for most surgical procedures covers both the procedure and post-operative visits occurring within a global period of 10 or 90 days following the procedure. From a CMS perspective, a visit that occurs in the interval between the decision making visit and the day of the surgery, even when it may be the preoperative history and physical, is only included in the global surgery package when it is performed on the day before or the day of the major surgery as per the designated global surgery period days (i.e. 92 days) for major surgeries. However, CPT, in their Surgery Guidelines section of the CPT manual includes the same items as CMS in their definition of the surgical package except CPT does not designate procedures as “minor” or “major” and does not assign any “global days” like CMS does for every procedure. Therefore, from a CPT reporting perspective any visit related to the surgery after decision for surgery has been made is included in the surgical package.
Thank you.