Urology Coding Alert

Question: What does the global surgical fee entail? For example, when we bill a surgery, how do we know what we can bill for in addition and what is included in the global?

Nevada Subscriber

Answer: Per Medicare, the global surgical package includes the following:

(1) preoperative visits beginning the day before the day of surgery for major procedures (90 days) and the day of surgery for minor procedures (0-10 days);

(2) intraoperative services (all services normally a usual and necessary part of the surgery);

(3) complications following surgery (all additional medical or surgical services required of the surgeon during the postoperative period of the surgery because of complications that do not require additional trips to the operating room);

(4) postoperative visits (follow-up visits during the postoperative period that are related to recovery from the surgery);

(5) postsurgical pain management;

(6) supplies; and

(7) miscellaneous (dressing changes, removal of cutaneous sutures and staples, lines, wires, tubes, drains; insertion, irrigation and removal of urinary catheters, routine peripheral intravenous lines, nasogastric and rectal tubes; and changes and removal of tracheostomy tubes).


Answers to You Be the Coder and Reader Questions provided by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stonybrook; Sandy Page, CPC, CCS-P, co-owner, Medical Practice Support Services, coding, compliance, and reimbursement consultancy, Denver; and Susan Callaway, CPC, CCS-P, independent coding auditor and trainer, North Augusta, S.C.