For every medical service, insurers and government programs have a window of time allotted for expected treatment including preoperative and postoperative care. During the allotted time window -- known as the global period -- physicians and medical facilities can bill all the treatments and interventions related to the primary procedure code in one, conglomerated bill. This simplifies billing for both medical provider and the insurer. Of course, the key is for medical billers to identify the correct global period to correspond with a procedure's CPT code, so they can plan their billing accordingly.
Download the most current physician fee schedule from the Center for Medicare and Medicaid Services website at www.cms.gov.
Find your desired CPT code and look at the "global period" column for its corresponding global period.
Use CMS' physician fee schedule search on the website. The application allows you to look up single codes or multiples. On the modifier pull-down bar on the bottom of the page, select "Global."
Call the patient's health insurer if you are dealing with a health plan which doesn't mirror CMS global period rules. In that situation, you have to get the answer directly from the provider.
Call CMS to order a print version of the physician fee schedule if downloading or online searching isn't comfortable or accessible for you. If you rely on a print schedule from CMS, then you'll need to check regularly for any updates or changes. Online searches will give you the most updated CMS information.
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