# 33208 global inclusions



## jazzyblues2005 (May 21, 2013)

Would an echo w/doppler (93306) be included in the 90 day global of 33208 or would you use a global modifier to distinguish it from that service? The reason the provider gave for doing the echo doesn't mention the pacemaker at all. I'm on the fence with this one.

Thanks!


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## AB87 (May 21, 2013)

This is very tough because if you do an Echo its almost assumed that you would like to view the placement of the pacemaker after the implantation. You would have to post a sample to get the best Answer IMO. The documentation would have to really be strong to support that its a *different Diagnosis/reason *for the test besides the pacemaker implantation.


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## jazzyblues2005 (Jul 15, 2013)

Thank you!


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## geigert (Jul 16, 2013)

Actually a 93306 would not be included in the global period.  Per CMS global surgery fact sheet "Diagnostic tests and procedures, including diagnostic radiological procedures" are not included in the global period.  You can also see that this is a billable service during the global period by going to the Medicare Fee Schedule and seeing that it has a Global Payment Policy Indicator of XXX, which means that the "global concept does not apply".
I have attached a link to the fact sheet below.

http://www.cms.gov/Outreach-and-Edu...oducts/downloads/GloballSurgery-ICN907166.pdf

You should be able to bill the 93306 with no modifier needed.


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## jazzyblues2005 (Jul 16, 2013)

Thank you, that is very helpful!


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