Wiki Global Surgical package assistance

SharonSP

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Wilkes-Barre, Pennsylvania
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Need clarification of global surgical package.

Pt had CABG and Maze procedure performed for CAD and A-fib. Pt continued to have atrial fib after Maze procedure and on post op day 5 surgeon performed cardioversion. The pt was brought to PACU and cardioversion was performed.

Can cardioversion be billed? I do not believe the cardioversion can be billed since the pt did not return to the OR.

Medicare defines OR as:

An OR, for this purpose, is defined as a place
of service specifically equipped and staffed for
the sole purpose of performing procedures. The
term includes a cardiac catheterization suite, a
laser suite, and an endoscopy suite. It does not
include a patient?s room, a minor treatment room,
a recovery room, or an intensive care unit (unless
the patient?s condition was so critical there would
be insufficient time for transportation to an OR);

Furthermore, if a surgical intervention for a related problem is performed in the global period, but does not require a return to the operating room then it is included in the surgical global fee and cannot be billed additionally.


Thank you for your assistance.
SS
 
Yes, however, the procedure was performed in the PACU, with moderate sedation, and I think you should bill with 92960-78; which specifies "unplanned return to the operating/procedure room by the...."

Patient continued to have a-fib post MAZE which was servere enough to require cardioversion to normal sinus rhythm.
 
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