Determining the Duration of a Global Period
To determine the global period for major surgeries, count one day immediately before the day of surgery, the day of surgery and the 90 days immediately following the day of surgery.
Example:
Date of surgery – January 5.
Preoperative period – January 4.
Last day of postoperative period – April 5.
To determine the global period for minor procedures, count the day of surgery and the appropriate number of days immediately following the date of surgery.
Example:
Procedure with 10 follow-up days:
o Date of surgery – January 5.
o Last day of postoperative period – January 15.
Billing Guidelines
The following table outlines the services included in the global surgical package:
Preoperative Visits
Preoperative visits begin with the day before the surgery for major procedures and the day of the surgery for minor procedures. The global package of care includes all visits related to the surgery, in or out of the hospital, on the day of the surgery.
Intraoperative Services
These are services that are normally a usual and necessary part of the surgical procedure.
Complications Following Services
These include all additional medical or surgical services required of the surgeon during the postoperative period of the surgery due to complications that do not require additional trips to the operating room.
Postoperative Visits
These are follow-up visits during the postoperative period of the surgery that are related to recovery from the surgery.
Postsurgical Pain Management by the Surgeon
Miscellaneous Services
These services include items such as dressing changes, local incision care and removal of operative pack. Removal of cutaneous sutures, staples, lines, wires, tubes, drains, casts and splints. Insertion irrigation and removal of urinary catheters, routine peripheral intravenous lines, nasogastric and rectal tubes, and changes and removal of tracheostomy tubes.
Supplies
Except for those identified as exclusions.
