10.01.009A RETIRED Global Surgical Care Rules
Governs how reimbursement is handled for surgical and select diagnostic procedures and related pre- and post-operative E/M visits when performed by the same provider/group; applies to CareFirst claims and providers (see referenced policy PP CO 070.03).
This policy is retired and is no longer in effect.
Global Surgical Coverage Criteria
Global surgical coverage criteria
Services included in or excluded from the global surgical allowance and rules governing separate reimbursement of E/M services.
ALL of the following
- Major procedures: global period includes 1 day pre-operatively through 90 days post-operatively (count 1 day immediately before the day of the procedure, the day of the procedure, and 90 days immediately following).
- Minor procedures: either 0 days (day of procedure only) or 0 day pre-op through 10 days post-op (count the day of the procedure and 10 days immediately following for 10-day).
ALL of the following
- Preoperative visits beginning one day before the day of the procedure for major procedures and the day of the procedure for minor procedures (except as noted for decision for surgery).
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