Wiki 99024 versus 99213s...99231s...for the new Hernia codes

[RALIM]

Good day! I need help figuring out what E&M to use for visits done after a hernia procedure from 2022. With the new Hernia codes effective January 2023, any services done on this date going forward, we will use the new Hernia codes and zero global period days applies.
But for Post Op visits/Follow up visits done for hernia procedures done prior to January 2023 with the old Hernia codes, what E&M should we be using for Post op or any Follow up visits done? Are we supposed to use the 99024-NC that applies for the old Hernia codes(90 global days) or we will honor the new Hernia codes with zero global days?
My own opinion I think is we need to use the 99024-NC because the CPT used is described with 90 global days period and they are correlated. I just need an expert opinion to explain to our doctors.
Thank you in advance for your help clarifying this issue.

 

[csperoni]

The new hernia codes have 0 global days. That means when their value was determined, the work for postop care was not estimated/calculated and incorporated into the value of the surgery codes. All visits after the day of surgery are billable at whatever the level of service is documented.
For any surgeries performed with the old codes, the postop work is included in the payment for the old codes. If you billed a hernia repair in 2022, then it doesn't matter that the new code has 0 global. The code you billed has 90 day global.
When surgery codes are valued, their value differs based on the global period as well as the amount of work for the surgery itself.
I hope that better explains it for you.

 

[thomas7331]

Agree with the above. The global period isn't established by CPT, it's a part of the payer's reimbursement policy involving the value assigned to a service. If you do not bill for the post-op visits for a 0-day procedure, then your providers are going to be incorrectly reimbursed for their work and will be underpaid.

Since the global period is 0 days, then you should treat the post-op visits as regular E/M services and assign the appropriate code (e.g. 99212-99215 if the visit takes place in the office) according to the documentation for that encounter as you would any other E/M service.