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  • Focus on the Fundamentals: Verify Global Periods - Because They Can Vary

    Payment for surgical procedure codes includes a defined period for the post-operative care. These defined days are known as the global period.

    The global period affects coding for additional services furnished by the same surgeon on the same day or during the global period within the same group practice. Insurance companies classify surgical procedures as either minor or major based on the length of their global period.

    Minor procedures have either 0 or 10 days of post-operative care. Major procedures have 90 days of post-operative care for Medicare Part B. Payers that do not follow the Center for Medicare & Medicaid Services (CMS) rules can have different global periods. For instance, Medicare could have a 10-day global period for YAG laser peripheral iridotomy 66761; but a commercial payer could have a 90-day global period for the same procedure.

    How do you determine the global period?

    • Look up the relative value units (RVU) or allowable assigned to the procedure code. Major procedures typically have higher RVUs.
    • Review the payer’s policy and/or website. Medicare Part B global designations are included in the CMS Physician Fee Schedule
    • Consult Academy coding products. Current global periods are included in the printed and electronic versions of Ophthalmic Coding Coach

    Category III codes are not assigned global surgical post-operative days. Commercial payers may assign these codes global periods in their unique policies. Make sure to inquire about the global period when calling to verify if prior authorization is required.