Pain procedures have a global period?

[Green Grass]

Hey guys, do pain procedures have a global period? For instance, surgeons are required to cover all complications related to a surgery for 90 days post op. Is pain the same?

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[deleted472101]

10 days with stim and pump implants and I THINK it's zero for other peocedures

 

[lord_jeebus]

Also 10 days for RF

 

[Green Grass]

Thanks guys

 

[Yo GabbaPentin]

I thought that it was either 7 or 10 days for epidural as well. Correct me if I am wrong.

 

[bedrock]

I don't think there is a global for "injections" such as an epidural, MBB, peripheral nerve block, knee injection, disco, etc.

There is a day 10 global on more "surgical" type procedures like stim/pump implants and RF ablation, which are all 10 days.

Over the years, I've only had to see an "injection" patient just a few times in the first 10 days, and I billed for those f/u visits.

The only thing I'm not sure about is stim trials, which by definition, could go for 1-2 weeks anyway. I have been told by several sources you can't bill for removing the stim leads, which is considered part of the original procedure.
However, I don't know if you would bill for seeing a patient with an issue 9 days after a trial. Thankfully I haven't run into that.

 

[Ducttape]

i was told in fellowship that removal of the stim leads and the subsequent follow up visit to determine efficacy were all part of the global period, as this was a trial and not a separate and self-contained procedure in and of itself. i could be wrong, but i have put the follow up visit under the global period, and would also do the same for any complication that reared its ugly head in the 2 weeks in between (hasnt happened yet )

 

[lonelobo]

http://www.anesthesiallc.com/public...future-elimination-of-global-surgical-periods

 

[painfree23]

Does anyone have any updated information on global period billing? I was told by my coder that pain doesn't have any global period, except for stim, true?

 

[AGDOC09]

I just had a f/u OV denied after a RF because it was within the global period. insurance said global period was 10 days

 

[lobelsteve]

Yup, rf, scs, kypho, and pnb. 1 visit within 10d included.

 

[painfree23]

Yup, rf, scs, kypho, and pnb. 1 visit within 10d included.

Soo what if you see them 2 weeks after for post op visit. Also, pnb - peripheral nerve block?

 

[lobelsteve]

Did not see number of days listed.

Yes pnb is 64640 in this case.

 

[cameroncarter]

Hi all, any updates on a “global period” for bread/butter procedures like epidurals, facet blocks etc?

My billing/coding person suggested I may not reimbursed for follow ups scheduled in first 10 business days.

 

[MitchLevi]

No global

 

[Ferrismonk]

Last I heard, SCS trial has a 10-day global and SCS implant has a 90 day global period.

Otherwise there is no global for anything we do.

Caveat: I'm not sure about pumps, interspinous spacers, MILD, or Intracept since I don't do those.

 

[RoloTomassi]

Billing consultant told us there's a 10 day for RFA, but not sure the source, never looked into it since we don't see them for >2 weeks after anyway

 

[Orin]

Hi all, any updates on a “global period” for bread/butter procedures like epidurals, facet blocks etc?

My billing/coding person suggested I may not reimbursed for follow ups scheduled in first 10 business days.

Global Surgery Calculator

Just look it up but they're correct for some things
The basic premise is simple blocks are 0 days, RFA or trials or kyphos or even an SCS implant is 10

A mild or Vertiflex is 90 days

 

[bedrock]

Any issues with a cervical RFA one week and lumbar MBB the next? I have a commercial insurance patient trying to get both RFA done this year.

 

[lobelsteve]

Last I heard, SCS trial has a 10-day global and SCS implant has a 90 day global period.

Otherwise there is no global for anything we do.

Caveat: I'm not sure about pumps, interspinous spacers, MILD, or Intracept since I don't do those.

Sounds incorrect. Any refs?

 

[MitchLevi]

No injection carries a global per my billing ppl. If there is a global on an RFA I wouldn't know anyways bc I don't see you for 4-6 weeks.

I thought perms were 10 days.

 

[GoBeers]

is there global period of 10 days between left and right RFA?

 

[TIVAndy]

is there global period of 10 days between left and right RFA?

that's why people do it 2 weeks apart (14 days) to avoid global

 

[TIVAndy]

advanced pain procedures - 10 days - RF, SCS, pump etc
vertiflex - 90 days

i believe there's a website you can put in the cpt and will tell you the global.

 

[painfree23]

that's why people do it 2 weeks apart (14 days) to avoid global

But then got to wait a year to repeat…just do both sides at once

 

[DrMDAware]

But then got to wait a year to repeat…just do both sides at once

If you do bilateral then you can attempt again in 6 months, right?

 

[lobelsteve]

Sounds incorrect. Any refs?

Global Surgery Data Collection | CMS

Data Collection on Resources Used in Furnishing Global ServicesMedicare payment for most surgical procedures covers both the procedure and post-operative visits occurring within a global period of either 010 or 090 days following the procedure. The Medicare Access and CHIP Reauthorization Act of...

www.cms.gov

Excel spreadsheet line 3800. 63685 10 days. 2021 was most recent year included.

 

[Ducttape]

Any issues with a cervical RFA one week and lumbar MBB the next? I have a commercial insurance patient trying to get both RFA done this year.

i have never had issues with this.

 

[mid|ine]

Any issues with a cervical RFA one week and lumbar MBB the next? I have a commercial insurance patient trying to get both RFA done this year.

Shouldn't be any issue. Different Dx code and different procedure code.

 

[painfree23]

Did our pain procedures used to have a global? If u do a epidural, patient with worsening pain 3 days later wants to be evaluated, that’s a regular follow up?