Cardiology Coding Alert

If you like codes with 0 day globals, you’ll cheer for this news.

CMS has proposed changing all 10 and 90 day global codes to be 0 day global codes starting in 2017.

Why? “The OIG has identified a number of surgical procedures that include more visits in the global period than are being furnished.” Because CMS seems to believe that Medicare is wasting cash by paying doctors for global periods that include visits the doctors don’t actually perform, CMS is proposing to include “all services provided on the day of surgery, and to pay separately for visits and services actually furnished after the day of the procedure,” CMS says.

Impact: This change would mean that you could bill any postoperative services on an a la carte basis instead of bundling all related post-operative care into the surgical charge. 

Whether this change bodes well for practices “really depends on how CMS decides to value the surgical codes once the agency removes the global periods from the value units,” says Marcella Bucknam, CPC, CPC-I, CCS-P, CPC-H, CCS, CPC-P, COBGC, CCC, internal audit manager with PeaceHealth in Vancouver, Wash.

Caution: If CMS goes through with this proposal, the agency will be watching patterns of billing post-op E/M services. “We [want to] ensure that allowing separate payment of E/M visits during post-operative periods does not incentivize otherwise unnecessary office visits during post-operative periods. If we adopt this proposal, we intend to monitor any changes in the utilization of E/M visits following its implementation.”

Learn more: You can read the CMS proposal and find out how to comment at www.federalregister.gov/articles/2014/07/11/2014-15948/medicare-program-revisions-to-payment-policies-under-the-physician-fee-schedule-clinical-laboratory.