tci Part B Insider - 2009 Issue 3

Part B Coding Coach: Bust 3 Myths About How Global Rules Affect Your Postop Coding

CMS and CPT disagree about one key term. If you automatically assume you can't separately report a surgeon's treatment of postoperative complications, you could be leaving money on the table. Knowing what qualifies as "typical" care will make your job easier. Myth #1: All Payers Treat Postop Claims the Same How you deal with postoperative complications depends on the payer you're dealing with, experts say. Medicare carriers treat postoperative complications differently than insurers that follow CPT guidelines. Although both CMS and CPT guidelines indicate that the global surgical package includes "typical" postsurgical care, the two groups vary on their...

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