Global surgical packages

Applies to:

All plans

Definition

CPT (Current Procedural Terminology) defines the surgical package as services provided by the physician for specific services that are

  • Included in a given CPT surgical code, and
  • Are always included in addition to the surgical procedure itself.

The services provided by a physician to any patient are by their very nature variable, but the global package remains the same. Global surgical package CPT codes are based on CMS (Centers for Medicare and Medicaid Services) methodologies.

Also see: DRG and outliers billing information.

Global surgical packages billing

Days included in a global surgical package

Settings

Pre-treatment day – day prior (major procedure) or day of (minor procedure)

Surgical services

Post-operative period

Clinical edit: surgical supplies

Claims will deny when surgical dressings A6010-A6011, A6021-A6025, A6196-A6224, A6228-A6248, A6250-A6262, A6266, A6402-A6404, A6407, A6413, A6441-A6456 are billed in the provider's office (POS 11). According to CMS policy, when a physician applies surgical dressings as part of a professional service, the surgical dressings are considered incident to the professional services of the health care practitioner and are not separately payable.