Minor or Major Surgery Claim Denials

Has your facility received denials when billing for services following a surgery with a 10-day or 90-day global period?

To access an overview of global period post-operative days, the Medicare Physician Fee Schedule (MPFS) Lookup Tool, billing details, and services included/excluded in global surgery payment information, visit the Global Surgery webpage. If interested in looking for a specific CPT code and verify its global period, access the appropriate state file on the Medicare Physician Fee Schedules (MPFS) webpage.

If the denial received is because of a clerical error, a Self-Service Reopening may be requested. If your facility would like to submit a Redetermination request(s), submit it via the Noridian Medicare Portal (NMP). For those providers who do not yet use NMP, please view registration and user/administrator details on the NMP webpage.

Last Updated Feb 28, 2019