General Surgery Coding Alert

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 the next step.

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 one 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 one percent of body area of infants and children [except 15050]).

Technical and coding advice for You Be the Coder and Reader Questions provided by Marcella Bucknam, CPC, CCS, CPC-H, CCS-P, charge capture manager for the University of Washington Physicians.