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Physicians, nurse practitioners and physician assistants in many specialties perform procedures in the office, surgery center or hospital. The payment for procedures includes some pre-op and post-op work, done by the clinician.
There are instances, however, when E/M services may be billed for an initial evaluation for a minor procedure and when E/M services may be billed in the post-op period. Knowing when to bill for these and when these E/M services are included in the global surgery payment is imperative. Surgeons and coders also need to know how to bill for additional surgical services in the post-op period.
Knowing the surgery coding guidelines related to procedures is essential to ensure practice revenue and for submitting claims that are compliant with CPT® and CMS rules.
Table of Contents
- Definition of global package
- Medicare fee schedule
- Bundling and NCCI
- Initial evaluations prior to minor procedure
- E/M and procedure of the same day
- Initial evaluations prior to major procedure
- Pre op evaluations
- Post op evaluations
- Multiple procedures
See our complete list of in-depth coding guides.
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