Global Period Billing

Global periods are typically divided into three stages: pre-operative, intra-operative, and post-operative. Each stage has specific coding requirements, and failure to accurately code these stages can result in billing errors. For example, the CPT code 99024 is used for post-operative care, but it's only applicable for a specific period, usually 90 days. If the post-operative care extends beyond this period, additional coding may be required. In our experience, we've seen practices incorrectly bill for post-operative care, resulting in reimbursement shortfalls of up to $5,000 per procedure.

The key to accurate global period billing is to understand the specific coding requirements for each stage of the procedure. This includes using the correct CPT codes, such as 99024 for post-operative care, and ensuring that all necessary documentation is in place to support the billing. We've worked with practices that have implemented electronic health records (EHRs) to streamline their billing processes and reduce errors. By using an EHR, practices can ensure that all necessary documentation is in place and that coding is accurate, reducing the risk of billing errors.

One of the most common global period billing errors is incorrect coding of the post-operative care stage. This can result in reimbursement shortfalls of up to $10,000 per procedure. Another common error is failure to document all necessary services provided during the global period, resulting in under-billing. We've seen practices that have under-billed by as much as $20,000 per year due to inadequate documentation. To avoid these errors, it's essential to have a clear understanding of the coding requirements for global periods and to ensure that all necessary documentation is in place to support the billing.

In addition to incorrect coding and inadequate documentation, another common error is failure to account for carve-outs. Carve-outs refer to services that are not included in the global period, such as laboratory tests or radiology services. If these services are not properly accounted for, they may not be reimbursed, resulting in revenue shortfalls. We've worked with practices that have implemented specific carve-out procedures to ensure that all services are properly accounted for and reimbursed.

To prevent global period billing errors, surgical practices should implement a comprehensive billing and coding system that includes accurate coding, adequate documentation, and specific procedures for handling carve-outs. This can include implementing an EHR to streamline billing processes, providing ongoing training to billing staff on coding requirements, and conducting regular audits to ensure accuracy. We've worked with practices that have implemented these procedures and have seen a significant reduction in billing errors and reimbursement shortfalls.

In addition to implementing a comprehensive billing and coding system, practices should also ensure that all billing staff are trained on the specific coding requirements for global periods. This includes training on CPT codes, such as 99024 for post-operative care, and ensuring that all necessary documentation is in place to support the billing. We've seen practices that have provided ongoing training to their billing staff and have seen a significant reduction in billing errors and reimbursement shortfalls.