Practice Management Alert

Question: When a self-pay patient has surgery in the hospital, do you still follow the insurance global guidelines for the billing for the post-op visits?

Minnesota Subscriber

Answer: Yes, you should still follow the global period rules. The type of insurance the patient has -- or a lack of insurance coverage -- does not affect the global period guidelines you should be following.

The "global surgical package" describes all services integral to a procedure as described by CPT. The payment for the primary procedures includes performing any of these "packaged" services, regardless of who you are billing for the service.

In other words: Most procedures include services that go beyond the procedure itself, and performing these services is an expected (and not separately reportable) part of providing the primary procedure.

Keep in mind: You do not have to follow Medicare's definition of global, which includes post-op complications. This means that if the patient is coming into your office for post-op complication treatment and not just normal post-op care, you can bill for the service.

-- The answers to the Reader Questions were reviewed by Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions in Tinton Falls, N.J. and senior coder and auditor for The Coding Network.