General Surgery Coding Alert

Question: How can I find the length of postoperative global periods for various procedures the surgeon performs?

Maine Subscriber

Answer: CMS publishes global surgical periods for all CPT codes each autumn in the Federal Register, but the most convenient and accessible place to find this information is in the Physician Fee Schedule database.

You can locate the global period information in column "O" (labeled "GLOBAL DAYS") of the fee schedule database. 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 10-day (e.g., 19101, Biopsy of breast; open, incisional) or zero-day (e.g., 19100, Biopsy of breast; percutaneous, needle core, not using imaging guidance [separate procedure]) global period.

CMS also specifies global periods of "XXX," "YYY" and "ZZZ." An XXX designation means that the global period concept does not apply to that particular code. 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 individual 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 graft, 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 code 15100 (... first 100 sq cm or less, or one percent of body area of infants and children [except 15050]).

CMS updates the Fee Schedule yearly, and you must always be sure to work from the most current file. You may download the information free of charge from the CMS Web site (www.cms.gov). After downloading the file, you may choose to view the fee schedule database in a variety of formats, including as a text (.txt) file or an easy-to-navigate Excel (.xls) file.