Resolved Global surgical indicator clarification needed

[DaneskaS_78707]

Hello, I am having a hard time understanding the global surgical package indicator XXX. Per CMS coding manual, the global concept does not apply to XXX procedures. Then the manual says that Many of the XXX procedures have inherent pre procedure, intra procedure and post procedure work performed each time the procedure is completed. My question is since the global concept does not apply to these procedure, can an E/M code be billed on the same day as an XXX procedure without use of a modifier since global concept does not apply? What seems to be throwing me off is the inherent pre procedure, intra procedure and post procedure information. I appreciate any guidance on this. Thanks

 

[Darcy]

the classification XXX (Global surgical rules do not apply) means that the service is truly free of global surgical bundling issues, and you can separately report services that you perform on the same date as the surgical procedure (such as E/M services). The 000 indicator applies to the date of the procedure only. Therefore, an E/M code can be billed on the same day as an XXX procedure without use of a modifier, as long as the E/M service is medically necessary and documented appropriately. However, you should always check with the specific payer’s policies and guidelines before billing both services.

 

[DaneskaS_78707]

Thanks for responding. One last question, the NCCI manual says that the inherent pre procedure, intra procedure and post procedure work shall not be reported with a separate e/m code. Would you know what e/m codes this statement is referring to?

 

[Alicia]

It would be all E/M codes. If it starts with a 99 and is an E/M you can't use them together. (and get paid)