Question: I see a lot of discussion about “global periods,” but I cannot find anything in CPT that defines the global period for any particular procedure. Where can I find this information?
Michigan Subscriber
Answer: You can find global-period information in the Medicare Physician Fee Schedule Database, available as a free download on the Medicare Web site at www.cms.hhs.gov/PhysicianFeeSched/.
Tip: If you cannot access the page in the link given above, go to the CMS home page (www.cms.hhs.gov/) and use the “search” function in the upper right-hand corner to find “physician fee schedule.” The first search result should specify “Physician Fee Schedule.” Click on this link to advance.
To find global-period information, you should look to the column of the database labeled “Global Days.”
Major surgical procedures (including common general surgery procedures such as hernia repairs, burn treatment, mastectomies, etc.) include a 90-day global period.
Lesser surgical procedures may include a global period of 10 days (for example, 19101, Biopsy of breast; open, incisional) or zero days (for example, 19100, Biopsy of breast; percutaneous, needle core, not using imaging guidance [separate procedure]).
An XXX designation means that the global-period concept does not apply. An example of this is 15850 (Removal of sutures under anesthesia [other than local], same surgeon).
The YYY global period applies only to unlisted-procedure codes (such as 37799, Unlisted procedure, vascular surgery) and indicates that the payer is free to determine a global period for the procedure.
The ZZZ designation denotes an add-on procedure for which the global period is included in the primary procedure. For instance, CMS bundles the global period for add-on procedure +15101 (Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm or each additional 1 percent of body area of infants and children, or part thereof [list separately in addition to code for primary procedure]) to the 90-day global period of the primary procedure 15100 (... first 100 sq cm or less, or 1 percent of body area of infants and children [except 15050]).
Reader Questions reviewed by Sarah L. Goodman, MBA, CPC-H, CCP, president of SLG Inc. in Raleigh, N.C.
