Outpatient Facility Coding Alert - 2013 Issue 4
Global Periods: Know When You Can -- and Can't -- Report an E/M Service During a Procedure's Global Period
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Article Overview
This article provides a practical overview of Medicare global period designations and the general circumstances in which evaluation and management services may be considered within or outside a procedure’s global package. It is aimed at coders, billers, and other revenue cycle professionals who need to understand how global periods affect claim reporting and payer policies. The discussion also highlights broad differences among global period types and notes that private payer policies may differ from Medicare.
Why This Topic Matters
Understanding global periods helps reduce denials, support compliant claim submission, and clarify when an E/M service may be associated with another procedure. It is important for anyone responsible for professional coding, charge capture, or claims review.
Article Sections
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Count Your Days for Major or Minor
Introduces the global period designations that are tied to defined postoperative timeframes and explains the general distinction between shorter and longer surgical periods.
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Manage 25 With Minor Procedures
Discusses how shorter global periods are treated in relation to same-day E/M reporting and the general documentation concept associated with separately identifiable services.
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Rely On 57 for E/M With Major Procedures
Covers the longer global period category and the general relationship between same-day or preoperative E/M services and major procedures.
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Avoid Pigeonholing Groups
Summarizes the remaining global period categories that do not use standard postoperative day counts and describes their broad placement within payer systems and procedure types.
What You Will Learn
- The main Medicare global period designations and how they are organized
- How global periods affect the general treatment of E/M services around procedures
- Why payer-specific global period policies may need confirmation
- Which broad procedure categories are commonly associated with special global period assignments
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Compliance and audit personnel
- Physician practice administrators
Codes Discussed
Modifiers Discussed
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