Billing 'Starred' Procedures: Report E/M Services During Global Periods to Boost Payment

Why This Topic Matters

Understanding these policy differences can help practices avoid missed reimbursement and anticipate denials when reporting services that may be treated differently by CPT and by specific payers.

Article Sections

1. Look for the '*' Before You Bill

   Introduces starred procedures and explains the general concept of separating procedure-related services from broader surgical packages under CPT guidance. The section also identifies common procedure types discussed in the article.

2. Apply Modifier -25 for Same-Day E/M Services

   Covers same-day evaluation and management reporting in the context of starred procedures and discusses the related CPT reporting approach. It includes a general example of how these services may appear together on a claim.

3. Anticipate E/M Service Denials

   Describes common payer responses when E/M services are reported with starred procedures and addresses appeal-related concerns at a high level. The section also introduces an alternate visit code used by some payers in this scenario.

4. Watch for Payer-Imposed Global Periods

   Explains how payer-specific global-period policies can differ from CPT expectations and affect follow-up care. The section discusses general handling of related and unrelated services during postoperative periods.