Medical billing specialists are required to understand and comply with the rules and terms associated with billing various insurances and Medicare. One of the terms that we may run into in billing is what’s called a “global period” in medical billing.
This term refers to the period of time that begins up to 24 hours before a surgical procedure starts. It ends at a period of time after the procedure has ended. That period varies based on the nature of the procedure.
Depending on what type of surgery is performed, there may be a follow-up period during which follow-up care is included in the payment for the procedure, and not separately payable. That care is considered “bundled” into the global surgery fee.
Important Must-Knows About Global Period In Medical Billing
- The global periods adopted by the Centers for Medicare & Medicaid Services are typically followed by other payers as well.
- Surgery reimbursement includes payment for all related services and supplies that are routine and needed for the procedure.
- A global surgery service can be completed in any setting, including hospitals, doctor’s offices, or an ambulatory surgery center.
Medicare payment for procedures includes a variety of services, such as:
- Pre-op services for minor or major procedures (one day before major surgery and the day of, for minor surgery)
- Intraoperative services that are a necessary part of the surgery
- Post-operative services, including items such as dressing changes or incision care, post-op pain management, removal of sutures, and more
- Supplies used that are required for and related to the surgery
Services that are not included in a global surgical package include services like consultations, other doctor’s services, treatment for underlying conditions, diagnostic tests that are outside of the surgical procedure, and more.
To ensure that all the proper services are billed to Medicare, it requires careful monitoring of the global fee periods. Understanding and using the codes correctly will help reduce inappropriate billing, denials or an interruption in medical services for the patient.
Contact MBA Medical with any questions.