| CPT | Medicare |
|---|---|
| The length of the postoperative follow-up period is open-ended (i.e., as long as is necessary for typical postoperative follow-up care to be completed). | The post-operative follow-up period is 90 days for major surgery and either zero or 10 days for minor surgery or endoscopy. |
How long is the post-operative period for a surgery?
10-Day Post-operative Period (other minor procedures). • No pre-operative period • Visit on day of the procedure is generally not payable as a separate service. • Total global period is 11 days. Count the day of the surgery and the 10 days immediately following the day of the surgery. 90-day Post-operative Period (major procedures).
Are post-operative visits included in the payment amount for surgery?
Feb 27, 2011 · Postoperative periods are generally designated as follows: Procedure Global Period. Major 90. Minor 0 or 10. Endoscopic 0. A surgery with 90 follow-up (postoperative) days is considered a major surgery. A surgery with zero to 10 follow-up (postoperative) days is considered a minor surgery.
Does Medicare cover surgical procedures?
For Medicare Part B: Minor procedures have either a 0- or 10-day global period; major procedures have a 90-day global period. For non-Medicare payers: Minor procedures have either a 0- or 10-day global period; major procedures have a 45-, 60-, …
When to report postoperative care as subsequent hospital care?
How long is the global period? Under Medicare, the global period includes a postoperative period for “minor surgeries” that is either 0 days or 10 days …
How many days is the Medicare postoperative period for minor procedures?
What is considered postoperative period?
What is included in 10-day global period?
What does Medicare define surgeries to include?
What is the generally accepted period considered to be for minor procedures?
What is the global period for minor procedures?
What is not included in global surgical package?
Is general anesthesia included in the surgical package?
How are global days counted?
When does the postoperative period end Animals?
Does Medicare cover elective surgery?
How long does it take for Medicare to approve a procedure?
Endoscopy Families and Payment Rules
- Medicare has special payment rules for multiple endoscopies performed on the same day during the same operative session. The chart below explains the process used for reimbursement when more than one endoscopy of the same family is performed on the same day. Medicare's payment rules are determined by classifying endoscopy procedures according to fa...
Related Endoscopy Family
- Medicare allows highest valued endoscopy at 100% when endoscopies are in the same family. 1. Find procedure with highest allowance 2. Subsequent related endoscopies are reimbursed based on difference between base (or mother) code and subsequent codes
Unrelated Endoscopies
- Endoscopies not in same family, with different base codes, are reimbursed according to multiple surgery rules. Indicator in M column is 2 or 3. 1. Find procedure with highest allowance 2. Other procedures are allowed at 50%
Two Sets of Unrelated Endoscopies
- Codes from each set are from same family. 1. Apply special endoscopy rule to each set separately 2. Apply multiple surgery rules
One Related and Two Unrelated Endoscopies
- There are times when related and unrelated endoscopy sets are done on the same day. 1. Organize related endoscopies into a group 2. Organize unrelated endoscopies into a group 3. Determine highest allowable amount in each group 4. Apply multiple surgery rules