Practice Management Alert

Question: I listened to a conference during which the speaker cautioned against billing during the global period of other procedures. I don't really understand global-period rules. 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 general surgery procedures such as hernia repairs, burn treatment, etc.) 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 (for example, 19101, Biopsy of breast; open, incisional) or zero days (for example, 19100, Biopsy of breast; percutaneous, needle core, not using imaging guidance [separate procedure]).

An XXX designation means that the global-period concept does not apply. 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 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 proce-dure. For instance, CMS bundles the global period for add-on procedure +15101 (Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1 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 15100 (... first 100 sq cm or less, or 1 percent of body area of infants and children [except 15050]).

-- The answers to the Reader Questions were provided and/or reviewed by Barbara J. Cobuzzi, MBA, CPC-OTO, CPC-H, CPC-P, CPC-I, CHCC, president of CRN Healthcare Solutions, a coding and reimbursement consulting firm in Tinton Falls, N.J.