tci Medicare Compliance & Reimbursement - 2018 Issue 12
Reader Question: Check MAC Rules for Non-Reimbursable Postoperative Visit Submissions
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Article Overview
This article addresses a common billing question about postoperative related evaluation and management services during the global surgery period. It discusses general claim handling expectations, the role of Medicare Administrative Contractor guidance, and the documentation-focused purpose of submitting non-payable postoperative claims. The piece is intended for coding and billing staff who need to understand how local policy may affect reporting practices for surgery-related follow-up care.
Why This Topic Matters
Postoperative visits can fall under different payer and MAC rules, so coding teams need to know when reporting is expected even if payment is not. Understanding the article helps practices align their internal workflow with local Medicare guidance and documentation requirements.
What You Will Learn
- How postoperative related E/M services are discussed in the context of the global surgery period.
- Why payer and MAC-specific policies matter for non-payable postoperative claim submission.
- What general documentation considerations apply to postoperative services within global surgery periods.
- Where to look for broader Medicare guidance on global surgery billing.
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance teams
- Surgical office staff
Codes Discussed
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