Wiki global surgical pacakage

[JayalakshmiF]

We have been reimbursing for X Rays done during the post op visits in office during global period. My understanding is that " Diagnostic procedures such as x-rays, ultrasound or other imaging services, laboratory, or durable medical equipment." are not included in the Global Surgery package. We got a claim today where in they have claimed only Technical Component for the X ray and not the complete x ray procedure ( both tech + professional component). They say that during post op office visits they only have been billing the TC components as professional component is the part of the global package.

I hope I have made my self clear enough ?! Can you advise if the professional component of x ray is part of the Global package and only technical part is not during post op visits in office ?

 

[newyearcafe]

Global Surgical Package

It is my understanding that any procedure related to the surgery provided by the surgeon is included in the global package. Services NOT included are:
1. services of other physicians except where the surgeon and the other physician agree on the transfer of care
2. Visits unrelated to the DX for which the procedure is performed (unless it's a complication)
3. TX for the underlying condition or an added course of TX which is not a part of the normal recovery from surgery
4. DX tests and procedures, including DX radiological procedures.
Hope this helps

 

[thomas7331]

Under CMS/Medicare policy, diagnostic tests are not part of the global surgical package, and in fact, Medicare will not even allow the global modifiers (24, 58, 78, 79) to be billed on a radiology service code. However, other payers may have different policies. I would review the policies of the payer who denied your claim for clarification, or have them direct you to something in writing to back up their denial.