decisionhealth Newsletters, Coder Pink Sheets - 2000 Issue 5 (May)
Don't bill separately for discharge summary in the 90-day global period
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Article Overview
This article addresses postoperative billing in the context of orthopedic surgery global periods, with emphasis on what is typically bundled into a major surgery package and how that affects separate reporting of follow-up services. It is aimed at orthopedic coders, physicians, and practice staff who need a general understanding of global surgical package concepts, Medicare-related guidance, and payer variation.
Why This Topic Matters
Understanding what is included in the global surgical period helps avoid incorrect separate billing and supports more consistent coding and reimbursement decisions for orthopedic procedures.
Article Sections
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Question and answer on discharge summary billing
Introduces the billing question raised by a total knee replacement case and the response regarding separate reporting within the surgical global period.
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Global period basics for surgery
Explains the general concept of global surgical packages, including different follow-up periods and the distinction between minor and major surgery.
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Preoperative services and Medicare considerations
Summarizes bundled preoperative work for planned surgery and notes general Medicare-related expectations for surgical evaluation and candidacy assessment.
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Services included during the major surgery period
Lists categories of intraoperative and immediate postoperative services commonly considered part of the surgical package in orthopedic surgery.
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Postoperative care and separate services by other physicians
Discusses follow-up care after surgery and the circumstances in which another physician’s unrelated visit may be billed separately during the global period.
What You Will Learn
- How global surgical periods are generally structured for major and minor procedures
- Which broad categories of surgical services are commonly bundled into an orthopedic global package
- How postoperative care is treated in relation to separate billing
- How payer type can affect reporting of preoperative evaluation services
- When a nonoperating physician’s unrelated visit may be considered separately payable
Who Should Read This
- Orthopedic coders
- Physicians
- Medical billing staff
- Practice managers
- Coding consultants
Codes Discussed
Modifiers Discussed
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