Medicare Compliance & Reimbursement

Question: We often need to know the global days of a procedure to help us determine coding issues such as what modifier to use or whether to code a separate E/M procedure. How can we quickly determine the Centers for Medicare & Medicaid Services’ (CMS) global period for any CPT^® code?

AAPC Forum Participant

Answer: If you subscribe to an online coding tool such as Codify, you can see the global period and lots of other payment and coverage information about each code when you look it up.

But you can also always find the global days on the Medicare Physician Fee Schedule (MPFS) website at www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx.

To find the global period, follow these steps once you’re at the website:

• Click on Start Search.
• Enter the CPT^® code in the HCPCS code search box, select “All Modifiers” from the drop-down menu in the Modifier box right below that, and click the “Submit” button at the bottom of the page.
• On the next screen, click on “Show All Columns.”
• Scroll right for the column marked “Global.”

Once you get to the global column, you will see one of the following seven codes. Only three, 000, 010 and 090, indicate a specific timeframe; but you should know the other codes, too, as they indicate whether the procedure may be related to the global concept in some way. The following table defines these codes:

Remember: You should always verify with third-party payers that they are following the Medicare guidelines before using the information for your claims.