Medicare Compliance & Reimbursement
Find Clarity on Global Surgery Inclusion
Question: A patient who鈥檚 a Medicare beneficiary had surgery. They were in a lot of pain after the surgery and have had several encounters with a pain specialist within our practice to try and manage it. Can I bill this as a separate service? New Mexico Subscriber Answer: According to the Medicare Learning Network (MLN) , the global surgical package includes 鈥渁ll necessary services normally provided by a provider (or members of the same group with the same specialty) before, during, and after a procedure. Providers in the same group practice, with the same specialty, must bill and accept payment as though they鈥檙e a single physician.鈥� The Centers for Medicare & Medicaid Services (CMS) says it created the global surgical package to make sure that Medicare Administrative Contractors (MACs) pay the same for services across jurisdictions. The booklet says specifically that postsurgical pain management is included in the global surgery payment. However, the booklet also specifies that the global surgery package is specialty-specific; so if there are multiple specialties involved, even within the same practice, they may not be considered part of the same payment. Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC
Medicare Compliance & Reimbursement
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Find Clarity on Global Surgery Inclusion
Question: A patient who鈥檚 a Medicare beneficiary had surgery. They were in a lot of [...]
