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10060 Global Period

  1. #11
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    Medical Coding Books
    Quote Originally Posted by mburgett View Post
    Our patient is similar, but with a slight twist. Initial I&D R breast abscess done in the ER on 12/20. Two days later she presented to our office for removal of packing, but additional work was necessary due to infection/drainage. Is the additional work billable in this type of scenario or is this included in the E/M?

    The complication is global since it did not require a return to the OR. Its not uncommon to get post op infection and removal of packing would be part of the normal follow up for an I&D.
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  2. Default
    A treatment room does not count as a return to the operating room.

    Per CMS: “The global surgery payment includes… all additional medical or surgical services… during the post-operative period of the surgery because of complications, which do not require additional trips to the operating room…. An OR, for this purpose, is defined as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient’s room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient’s condition was so critical there would be insufficient time for transportation to an OR).” http://www.cms.gov/Outreach-and-Educ...-ICN907166.pdf

  3. #13
    Location
    Stuart, Florida
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    82
    Default Global surgery package
    Quote Originally Posted by khristinelouise View Post
    I am having the same problem. I understand that 10060 has a 10-day global but what happens if there are complications followups for infections and repacking of wound?
    If it is a complication that does not require a trip back to the OR, the visit is included in post op.

    From CMS directly, and OR is defined as, "...a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient’s room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient’s condition was so critical there would be insufficient time for transportation to an OR);"....meaning not the exam room in the physician's office...

    From the CMS manual: Medicare includes the following services in the global surgery payment when they provide them in addition to the surgery:
    • Pre-operative visits after the decision is made to operate. For major procedures, this includes preoperative visits the day before the day of surgery. For minor procedures, this includes pre-operative visits the day of surgery;
    • Intra-operative services that are normally a usual and necessary part of a surgical procedure;
    • All additional medical or surgical services required of the surgeon during the post-operative period of the surgery because of complications, which do not require additional trips to the operating room;
    • Follow-up visits during the post-operative period of the surgery that are related to recovery from the surgery;
    • Post-surgical pain management by the surgeon;
    • Supplies, except for those identified as exclusions; and
    • Miscellaneous services, such as dressing changes, local incision care, removal of operative pack, removal of cutaneous sutures and staples,
    lines, wires, tubes, drains, casts, and splints; insertion, irrigation and removal of urinary catheters, routine peripheral intravenous lines,
    nasogastric and rectal tubes; and changes and removal of tracheostomy tubes.
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