Inpatient Facility Coding & Compliance Alert

Question: If my doctor performs a procedure with a 90-day global period and he has subsequent hospital visits that are related to the surgery, are those hospital visits included in the 90-day surgical global period?

Wisconsin Subscriber

Answer: Under the Medicare Global Surgical Package (GSP), all postoperative visits during the surgery’s 90-day global period as well as the day before surgery and the day of surgery are included in the reimbursement for the surgical procedure itself.  Note that private payers may have different post-operative periods.

Under rare and rather unusual circumstances, if a hospital visit is completely unrelated to the post-operative care, you can bill for a hospital E/M visit and apply modifier 24 (Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period).