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Global Period Billing


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I see alot of 2 week post op Hip and Knee replacements. Until now I have always circled the global period no charge fee.

I've been told that if you ask them about immunodeficiney issues that could effect the outcome of the procedure and healing (ie smoking, dm, vit d deficiency) then you can bill as a level 1. Is this true? Is there any way that I can bill and get RVU for a simple 2 week post of a TKA or THA?

Thank you

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I agree with the Rev, that you should talk to your billers and coders. On most significant surgeries, the global period is 90 days, and the post op care that you provide is included in the initial fee for the procedure. I can think of no reason that anything in the ROS would change global coverage. You also should have asked these pertinent ROS and PMHx questions at preop to better do informed consent (which I'm sure that you did). The bottom line is that you can code visits anyway you want, but I can guarantee you that the carrier will deny payment for any and all postoperative care in the global period regardless as to what you document.

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