Certified Medical Assistant (CMA AAMA)Administrative: Billing, Coding and SchedulingMedium
A medical assistant is processing a claim for a patient who underwent a minor surgical procedure in the physician's office. The procedure has a 10-day global period. If the patient returns for a routine post-operative check-up related to the surgery within this 10-day period, how should the follow-up visit be billed?
- ABill with a separate E/M code and modifier -57.
- BBill with a separate E/M code and modifier -24.
- CBill with the surgical code again and modifier -78.
- DIt is included in the global surgical package and should not be billed separately.
Show answer & explanationAnswer & explanation
Correct answer: D. It is included in the global surgical package and should not be billed separately.
A global surgical package includes all necessary services normally furnished by a surgeon before, during, and after the procedure. Routine follow-up care within the global period is considered part of the original surgical fee and should not be billed separately.
Why the other options are wrong
- A. Modifier -57 is for a decision for surgery on the day of or day before a major surgery, not for post-op care.
- B. Modifier -24 is for an unrelated E/M service during a global period, which is not the case for a routine post-op.
- C. Modifier -78 is for an unplanned return to the operating room during the post-op period, not a routine follow-up.
Global Surgical Package
A bundled payment for all necessary services performed by a surgeon before, during, and after a surgical procedure for a specified period (global period).
- Includes pre-operative, intra-operative, and post-operative care.
- Routine follow-up visits within the global period are not billed separately.
- Global periods vary (0, 10, or 90 days).
Memory trick: Global: 'G' for Grouped, 'G' for General care included.