tci Medicare Compliance & Reimbursement - 2007 Issue 21

PART B: Heads Up, Physicians--The World Doesn't Always Revolve Around The Global Period

The end of surgery doesn't have to be the end of your reimbursement.Myth: You can't bill for post-operative complications during a global period, unless the patient returns to the operating room.Reality: Medicare won't pay for post-op complications outside of the OR. But the American Medical Association's CPT coding rules say the global period should only include "uncomplicated care," says Barbara Cobuzzi, president of CRN Healthcare Solutions in Tinton Falls, NJ. And many non-Medicare payors will reimburse these complications in any setting. This is one of many cases in which CPT and reimbursement rules 'bump heads...

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