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Thread: Need help on global period ASAP

  1. #1
    Join Date
    Apr 2007
    Daytona Beach, FL

    Question Need help on global period ASAP

    AAPC: Back to School
    Hi everyone - I have an issue I need to settle for our Plastic Surgeon - hopefully someone can answer this for me.

    The surgeon took the patient to the OR and performed a lesion removal of a melanoma, with a complex closure (global is 10 days). The patient returned to ER 6 days later with drainage from the incision site and the ER doc called in the Plastic Surgeon for a consult. Now our surgeon wants to bill for the Consult. I explained to her that it is part of the global as this was a complication from the surgery (this is a Medicare patient). She is insisting that it should be covered because she ordered an INR for the patient who is on Coumadin and wants me to bill with 24 modifier. I tried explaining that this is still global as the reason for the visit was for the surgical wound, but she wants verification of this.

    Can some one let me know if I am right or wrong and where I can get this information in writing. She is also upset about not knowing how to figure out what the global period is on her procedures. All of my other surgeons or their office staff always knew what the global period was for the surgeries they performed and I did not have to provide them this information. Is there a source where I can send her so that she or her staff can look up this information so that she knows when to charge for an office visit or when it is global.

    Thanks for any help!
    Jodi Dibble, CPC

  2. #2
    Join Date
    Apr 2007
    Dover Seacoast New Hampshire


    Use Chapter 1 of the NCCI edits to provide an overview of what's considered in the global surgical package. Chapter 3 discusses the integumentary surgeries...and has a section on appropriate use of E&M during the global days.

    Use the physician service fee schedule to run a report of your commonly billed procedures, to determine the global days. I drop these into an excel spreadsheet,and hand them out to the providers, so nobody is surprised when I mention "unbundling".

    Good luck!
    Pam Brooks, MHA, CPC, PCS, COC
    Coding Manager
    Wentworth-Douglass Hospital
    Dover, NH 03820

    If you can dream it, you can do it. Walt Disney

  3. #3
    Join Date
    Apr 2007
    Daytona Beach, FL


    Thanks Pam - these sites were very helpful and I will be forwarding this info on to my Plastic Surgeon.
    Jodi Dibble, CPC

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