Ophthalmology and Optometry Coding Alert

Question: I listened to a conference during which the speaker cautioned against billing during the global period of other procedures. Where can I find information on global periods?

Idaho 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 http://www.cms.hhs.gov/PhysicianFeeSched/. To find global-period information, you should look to the column of the database labeled "Global Days."

How it works: Major surgical procedures (including common ophthalmic surgeries such as cataract surgery and glaucoma surgery) include a 90-day global period (90 days plus the day before the surgery). Lesser surgical procedures may include a global period of 10 days (e.g., 67800, Excision of chalazion; single) or zero days (e.g., 67820, Correction of trichiasis; epilation, by forceps only).

An XXX designation means that the global-period concept does not apply. An example of this is 65771 (Radial keratotomy).

The YYY global period applies only to unlisted-procedure codes (such as 67299, Unlisted procedure, posterior segment) 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 +67320 (Transposition procedure [e.g., for paretic extraocular muscle], any extraocular muscle [specify] [list separately in addition to code for primary procedure]) to the 90-day global period of the primary procedures 67311-67318 (Strabismus surgery ...).

��" Advice for You Be the Coder and Reader Questions provided by Maggie M. Mac, CMM, CPC, CMSCS, consulting manager for Pershing, Yoakley and Associates in Clearwater, Fla.