Wiki First Post-Op Visit After 10-Day Global

[SSThomas03]

Patient presented for first post-op visit after the 10-day global period of a procedure. I know the visit is billable, because it falls outside the global period. However, I was informed not to do that as best practice. Can anyone direct me where I can find information to support that?

 

[amyjph]

If the global days are up, the global days are up.

However, in some of my experiences, providers have chosen to allow for it if for example, they could not get the patient in within the 10 days due to scheduling issues. Also unfortunately, sometimes patients are misinformed by front desk staff or others that may not be involved in coding that all procedures have a 90 day global which causes patient upset.
Of course there are other guidelines such as unrelated E/M or procedure during a global for a different problem, etc. and a payer may have a different guideline.

 

[csperoni]

Yes, exactly what Amy said above. From a coding standpoint, day 11 is day 11 and the visit is billable. From a customer service standpoint, if the provider's schedule was full, or on vacation, or otherwise not available to see the patient within the global timeframe, (or no one realized there was a 10 day global to even try to schedule within 10 days), then some practices will not bill it to insurance and consider it part of the global care.
This is a practice business decision and there will not be any official guidelines about this.