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Printed Date: 9/22/2015
Medicare reimbursement for surgical procedures is based on a package of care that includes preoperative, intraoperative and postoperative care. When the package of care is split among multiple physicians or other health care practitioners, claims must be submitted according to these instructions in order for each physician to be reimbursed appropriately.
Physicians Who Furnish the Entire Global Surgery Package
Physicians who perform a surgery and furnish all of the usual pre- and postoperative work for the global package will report the appropriate surgical code only.
Physicians in a Group Practice
Physicians Who Furnish Part of a Global Surgery Package: Split Post-Op Care
When physicians provide only part of the care in the global surgery package, each physician involved in the surgical and postoperative care must identify the specific services he/she provides. Payment for the postoperative, post-discharge care is split between two or more physicians where the physicians agree on the transfer of post-operative care.
Example of Split Postoperative Care
Patient A has a cataract removed from her left eye on January 17, by Dr. X. The surgery took place in an ambulatory surgical center (ASC). Dr. X follows her postoperatively for the first 10 days, then transfers the remainder of her postoperative care to Dr. Y.
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Last Updated: 08/22/2018