Changes to Reporting 10- and 90- Day Global Codes: What Ob-Gyns Need to Know

The Center for Medicare and Medicaid Services (CMS) is implementing new mandatory post-operative visit reporting requirements effective on July 1, 2017 for services provided to patients with traditional Medicare.  Ob-gyns and other practitioners will be required to report CPT code 99024 (Post-operative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a post-operative period for a reason(s) related to the original procedure) for each postoperative visit they provide within the global period for specific services.

This new reporting requirement affects ob-gyns who are part of practices with 10 or more practitioners and who live in one of the following nine specified states: Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island.

This is a new requirement from CMS as specified in the Medicare Access and CHIP Reauthorization Act (MACRA) to allow CMS to gather enough data on postoperative visits to revalue global codes starting in 2019. This new reporting requirement is intended to help the agency determine if the post-op visits that are currently valued into global codes are actually being performed. The valuation of the global surgical packages may be adjusted if CMS determines that the number of actual post-op visits differs from what has been valued in the global package.

CMS has published the list of CPT codes affected by the new policy. These global period codes were chosen by CMS if the service was furnished by more than 100 practitioners and are either billed more than 10,000 times or have allowed charges of more than $10 million annually. The list below includes the following CPT codes commonly used by ob-gyns. Please review the entire list in case your practice uses other included codes.

  • CPT 38571 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy)

  • CPT 57240 (Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele)

  • CPT 57288 (Sling operation for stress incontinence (e.g., fascia or synthetic))

  • CPT 58571 (Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s))

  • CPT 58661 (Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy))

  • CPT 64555 (Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve))

  • CPT 64561 (Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed)

  • CPT 64581 (Incision for implantation of neurostimulator electrode array; sacral nerve (transforaminal placement))

For more detailed information and FAQs, see the CMS website for the recording, transcript, and slide deck of a CMS hosted call from April 25.

 

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