AMA CPT® Assistant - 2015 Issue 3 (March)
CPT Surgical Package Definition (March 2015)
March 2015 pages 3-4 CPT Surgical Package Definition The concept of a global payment for surgeries and procedures represented by a Current Procedural Terminology (CPT®) code was introduced with the implementation of the Resource Based Relative Value System (RBRVS) in 1992. This concept describes the components of the global surgical package. The global surgical package concept in CPT includes the pre-operative, intra-operative, and post-operative surgical services. Certain pre-operative services, performance of the surgical procedure (including procedures that are an integral component of a procedure), and all uncomplicated follow-up care are included in the CPT surgical package. This article...
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Article Overview
This article explains the CPT surgical package concept as updated for 2015 and places it in context with the CMS and CPT Surgery Guidelines. It is aimed at coders, billers, and clinicians who need a broad understanding of how surgical services, related E/M services, and postoperative follow-up are grouped or distinguished for reporting. The article includes general guidance and clinical examples showing common scenarios, along with references to modifier use and selected CPT examples.
Why This Topic Matters
Understanding the surgical package is important for accurate reporting of surgery-related services, especially when deciding whether preoperative, intraoperative, postoperative, or related E/M services belong on a separate claim line. The topic is relevant to avoiding inconsistent billing across different payer policies and clarifying how CPT and CMS perspectives align or differ.
Article Sections
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March 2015 pages 3-4
Introduces the article’s scope and the 2015 update to the CPT surgical package discussion.
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CPT Surgical Package Definition
Describes the overall structure of the CPT surgical package and the broad categories of services included in the concept.
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Reporting Evaluation and Management (E/M) Services
Explains how the article frames E/M services in relation to the surgical package and discusses illustrative scenarios.
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Post-Procedure Follow-up Care
Summarizes the article’s discussion of postoperative and follow-up care considerations, including how they are treated in the context of surgery-related reporting.
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Third-Party Payer Global Surgery Definitions
Notes that payer policies may vary and describes the article’s broader point about differences in global surgery definitions.
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Minor Surgeries and Endoscopies
Covers the article’s general discussion of same-day services and global period considerations for minor procedures and endoscopic services.
What You Will Learn
- How the CPT surgical package is described in the article
- How the article frames surgical services before and after a procedure
- How E/M services are discussed in relation to surgery
- How postoperative follow-up care is addressed
- How payer-specific global surgery concepts are contrasted at a high level
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Physicians and other qualified health care professionals
- Revenue cycle professionals
Codes Discussed
Modifiers Discussed
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