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
• Modifiers
• Multiple procedures

See our complete list of in-depth coding guides.