Billing: CMS to Institute Payment Edits for E/M Services During Global

Why This Topic Matters

The article matters because it signals Medicare claims review changes that could affect payment for common outpatient and surgical services. Readers can use it to identify which service categories are under increased scrutiny and which CMS transmittals are driving the updates.

Article Sections

1. E/M Services Performed During the Global Period

   This section discusses Medicare review of evaluation and management services reported during surgical global periods and the related documentation focus described in the CMS transmittals.

2. Untimed Therapy Codes

   This section covers CMS attention to untimed therapy reporting and the claim edits tied to repeated billing patterns.

3. E/M With Pulmonary Diagnostic Testing

   This section addresses combined reporting of evaluation and management services with pulmonary diagnostic testing and the planned Medicare edit activity.

4. Initial IV Hydration Codes

   This section outlines CMS guidance on initial infusion reporting and related claim handling issues for intravenous hydration services.

5. Modifier 62

   This section discusses two-surgeon claims and the upcoming CMS edit focus on modifier use and supporting documentation.