# 10 Day Global Period Help Please



## cmac

Does anyone know for sure or know of a site that can provide me with this information? When a patient has a procedure that has a 10 day global period, do you start counting the 10 days the day of the procedure or do you start counting the day after the procedure? I've always counted the day of but an employee has brought this to my attention and now I'm questioning it. 
Example: pt has procedure on 6/26/09; would global period go to 7/4 or 7/5?
Thanks!


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## ARCPC9491

I've always counted the day of the procedure but I don't have this in writing. 

From a practical sense, if the procedure is performed at 6am and is followed up on at 5pm, the 5pm visit is in the global, so it starts the day of.


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## dpeterson39

Your written documentation is in CPT Nomenclature under the introduction to the surgery guidelines:
*CPT Surgical Package Definition*

_The services provided by the physician to any patient by their very nature are variable. The CPT codes that represent a readily identifiable surgical procedure thereby include, on a procedure-by-procedure basis, a variety of services. In defining the specific services "included" in a given CPT surgical code, the following services are always included in addition to the operation per se: _

_Local infiltration, metacarpal/metatarsal/digital block or topical anesthesia _

_Subsequent to the decision for surgery, one related Evaluation and Management (E/M) encounter on the date immediately prior to or on the date of procedure __(including history and physical) _

_Immediate postoperative care, including dictating operative notes, talking with the family and other physicians _

_Writing orders _

_Evaluating the patient in the postanesthesia recovery area _

_Typical postoperative follow-up care_

Keep in mind that if a medical condition outside of the reason for surgery comes up within the global an e&m or another service, these may be reported separately with the appropriate modifier. Also, the H&P is subjective depending on your specific factors for a patient, in other words; this may be separately reportable as well.


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## moricecrys

cmac said:


> Does anyone know for sure or know of a site that can provide me with this information? When a patient has a procedure that has a 10 day global period, do you start counting the 10 days the day of the procedure or do you start counting the day after the procedure? I've always counted the day of but an employee has brought this to my attention and now I'm questioning it.
> Example: pt has procedure on 6/26/09; would global period go to 7/4 or 7/5?
> Thanks!




It depends on the surgery.....90 global procedures start the day before...this website will definitley help you....lamedicare.com

http://lamedicare.com/provider/provnewslet/pdfformat/igspe2009b.pdf


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## pamtienter

The 10 day global period includes the day of surgery but the actual "counting" beings the day after the surgery. 

The 90 day global period includes the day before the surgery (one day pre-operative period) but the 90 days begin the day after the surgery also. 

The information is on the CMS website with the Physician Fee Schedule. 
http://www.cms.hhs.gov/PhysicianFee...=ascending&itemID=CMS1218948&intNumPerPage=10
Open the zip file and check out the pdf file under "Global Days". It explains each of them there.

So, in your example, if the patient has a procedure on 6/26/09 with a 10 day global, you'd count 6/27/09 as day one and the last day in the global period would be 7/6/09.


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## Erica1217

cmac said:


> Does anyone know for sure or know of a site that can provide me with this information? When a patient has a procedure that has a 10 day global period, do you start counting the 10 days the day of the procedure or do you start counting the day after the procedure? I've always counted the day of but an employee has brought this to my attention and now I'm questioning it.
> Example: pt has procedure on 6/26/09; would global period go to 7/4 or 7/5?
> Thanks!



In your scenario, the global period would END on 7.6.09.  You start counting the day after the procedure.  

Here's a global days calculator that does the thinking for you - but only for for the 90-day ones - http://www.medicarenhic.com/providers/billing/billing_calc_global_period.html


 Erica


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