Global Period for Surgical Procedures

Global Period for Surgical Procedures from a Medicare perspective, surgical procedures include the following services when furnished by the physician who performs the surgery:

The decision for surgery is not part of the surgical package and should be separately coded using an E/M code.

Preoperative visits after the decision is made to operate beginning with the day before the day of surgery for major procedures and the day of surgery for minor procedures;
Intraoperative services that are a usual and necessary part of a surgical procedure;
All additional medical or surgical services required of the physician during the postoperative period of the surgery because of complications not requiring additional trips to the operating room;
Follow-up visits during the postoperative period of the surgery that are related to recovery from the surgery;
Postsurgical pain management;
Certain supplies;
Miscellaneous services (e.g., dressing changes; local incision care; removal of operative packs; 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).

There are a few distinctions between the Medicare and CPT package:
First, unlike CPT, Medicare includes in the surgical package treatment of complications that do not require additional trips to the operating room.
Second, unlike CPT, the postoperative part of Medicare's global period is not open-ended. Medicare assigns postoperative global periods of 90 days to major surgeries and either zero or 10 days to minor surgeries and endoscopies. Any services beyond the Medicare postoperative global period, even if related to the procedure, are separately reportable.

Calculating Global Period for Surgical Procedures:

Each surgery CPT has a Global surgery status indicator in which the minor surgery has Global surgery status indicator of 10 days and the major surgery has Global surgery status indicator of 90 days.

To determine the global period for minor surgeries:

Count the day of surgery (Pre-operative and Intra-operative services would be on the same day of surgery) and 10 days immediately following the date of surgery.

To determine the global period for major surgeries:

Count 1 day immediately before the day of surgery (Pre-operative), the day of surgery (Intra-operative), and the 90 days immediately following the date of surgery (Post-operative / follow ups)

Global Period for Surgical Procedures calculator for the major surgery is available at

http://www.medicarenhic.com/providers/billing/billing_calc_global_period.html



Tags: Global Period for Surgical Procedures, Global Period for Surgical Procedures