Global Surgical Packages
Effective for dates of adjudication 10/1/06 and thereafter, Medicaid will adopt Medicare’s RVU file designation for global surgical days. In the past and through date of adjudication September 30, 2006, Medicaid has used a 62 day post op period after major surgeries.
Effective for dates of adjudication 10/1/06 and thereafter, Medicaid will use a zero, 10 day, and 90 day post op period for routine surgical care. The codes in the following list include a 10 day post op period and an office, hospital, or outpatient visit for routine post op care should not be billed
within 10 days of surgery. Claims for these services will be subject to post payment review.
The major surgery codes that include a 90 day post op period will not be published. Post operative office visits for routine surgical care should not be billed as they are considered inclusive of the global surgical package. Additionally, surgical procedure codes with zero day post op period are not
published and may be located on the Medicare RVU file. Procedure Codes that include 10 day pos t op care:
FROM TO FROM TO FROM TO
10040 10180 31000 31002 54505
11010 31239 54620
11043 11044 31290 31294 54700
11200 36470 36471 55100
11400 11446 36557 36566 55450
11600 11646 36570 36571 55705 55706
11750 11752 36576 36578 56405 56515
11760 11770 36581 36583 56700
12001 13101 36585 36590 56740 56800
37609
13120 13121 38230 56810
13131 13132 38300 57000
13150 13152 38500 57022 57065
15340 38510 57105
15786 38570 38572 57130 57135
17000 39400 57180
17004 40800 40805 57415
17110 17111 40808 40812 57505 57513
17260 17286 40820 40831 57558
17340 17360 41000 41005
19101 41010 58120
20000 20005 41100 41110 58345 58356
20100 20103 41115 58350
20240 20251 41250 41252 58615
20500 41530 58661
20520 20525 41800 41806 59160 59841
20615 20650 41822 59840
20665 20670 41825 41826 60000
21076 41828 41830 61888
21085 42000 42106 62194 62264
21315 21320 42160 42182 62263 62282
21355 21356 42280 42281 62350 62365
FROM TO FROM TO FROM TO
21550 42310 42330 63650 63688
21920 42405
22505 22521 42700 42720
22523 22524 42800 42809
23030 23031 42900
23065 42960
23075 43750
23330 45005
23700 45900 45915 65270
23930 23931 46020 46030 65855 66030
24065 46050
24200 46080 46083 67345 67805
24640 46220 46230
25065 46320 46505 67825 67850
26010 26011 46706
27040 46754 67930
27086 46900 46924 67938
27256 27257 46935 68020 68115
27275 68110
27323 46940 46942 68135
27570 47382 68371 68440
27605 27606 47525 68400
27613 48102 68530
27860 49320 49322 68705 68761
28001 28002 49324 49325 68760 68840
28190 49422 49429 68801 69020
28630 28636 49436 49442 69000
28660 28666 50592 50593 69205
30000 30020 50688 69222 69421
30110 51010 51710 69405 69436
30210 30310 51705
30560 53000 69540
30801 30802 53060 53275 69610
30930 53260 54065
54000 54065
54105 54200
