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Thread: Global Days

  1. #1
    Join Date
    Apr 2007
    Salem, NH

    Default Global Days

    AAPC: Back to School
    We are having a discussion in my office in regards to pre op appts. Is it just the day before the surgery that is considered preop? We have a provider that wants to bill office visits if the patient is seen any other day than the day before the scheduled surgery. I know about global days after but was wondering if someone could clarify the preop global.


  2. #2
    Join Date
    Apr 2007


    For a surgery with a 90 day global period, the visit the day before the surgery is included in the global period (unless it was the visit where the decision for surgery was made then it can be billed with the 57 modifier). Just the visit one day before, then 90 days after. So if the pre-op was done 2 or more days before the surgery, it could be billed.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

  3. #3


    Unless this visit was for something entirely unrelated to the surgery, I wouldn't bill for the service. The H&P would be included in the surgical global package, unless this was the decision for surgery occurring either on the same day of surgery or one day prior.


  4. #4
    Join Date
    Apr 2007
    Duluth, Minnesota


    bpct6501 is correct on the global package, preops - you can't charge for the preop if it's done the day before major surgery (90 day global) UNLESS it's a decision to do surgery then you'd append modifier 57 to the E/M... You can't charge preop if it's done the day of minor surgery. (again, UNLESS it's the decision for surgery and then again append modifier 57 to the E/M). Many patients get sent back to their primary care physician for the preop, their provider should be paid for their services (E/M preop clearance). There's a reason the clearance is needed (usually). *These are not the same as the review with the patient "refer to H&P" before surgery chat (day of, as they're being wheeled in) * ...
    Last edited by dmaec; 12-10-2008 at 11:14 AM.
    Donna, CPC, CPC-H

  5. #5
    Join Date
    Apr 2007
    Milwaukee WI

    Default Who's providing the pre-op exam?

    If the surgeon has made the decision for surgery previously and is asking the patient to come in 4 days prior to get the H&P done, this should NOT be billed. There's no medical necessity for this visit; scheduling it outside the usual global pre-op window doesn't make it medically necessary and billable.

    If the surgeon has requested pre-op clearance from the PMD for a co-morbidity, that's possibly a consult, and it is billable by the PMD (whether a consult or an established visit). If the surgeon is sending the patient to the PMD just to avoid doing the H&P work him/herself, shame on the surgeon.

    I know, the surgeons say they can't be paid for the service otherwise. But they ARE compensated for this service. It's included in the RVUs for the surgery.

    F Tessa Bartels, CPC, CPC-E/M

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