Part B Coding Coach: Bust 3 Myths About How Global Rules Affect Your Postop Coding

Why This Topic Matters

Postoperative claims can be handled differently depending on whether a payer follows CMS or CPT guidance, so understanding the distinction helps support accurate reporting and avoid missed reimbursement opportunities.

Article Sections

1. Myth #1: All Payers Treat Postop Claims the Same

   Compares how Medicare/CMS and CPT-based payers view postoperative complications and global-period services. Highlights the article’s focus on differing definitions of typical care and how those differences affect reporting considerations.

2. Myth #2: You Don't Need a Modifier for Postop Services

   Discusses postoperative evaluation and management services during the global period and the need for modifier use under certain payer policies. Also addresses return-to-the-operating-room scenarios and distinguishes between different kinds of postoperative reporting situations.

3. Myth #3: CMS and CPT Agree About "Related"

   Explains the article’s comparison of CMS and CPT views on whether subsequent procedures are considered related or unrelated. Includes discussion of postoperative complications, office-based treatment, and payer-specific reporting implications.