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Global Surgery Data Collection and Reporting for Post-Operative Care

The Centers for Medicare and Medicaid Services (CMS) finalized a policy, required by the Medicare Access and CHIP Reauthorization Act (MACRA), in which some physicians that provide 10- and 90-day global services would be required to report information on the number of postoperative visits they provide.

Who will be required to report post-operative care information?

Practitioners in 9 states, Florida, Kentucky, Louisiana, Nevada, New Jersey, North Dakota, Ohio, Oregon, and Rhode Island, are required to report on claims data on post-operative visits furnished during the global period of specified procedures.

This will only affect practitioners in the above listed states who belong to groups of 10 practitioners or more.

What will need to be reported? And how will it be reported?

Practitioners who meet requirements and perform any of the 293 codes that have been identified will report post-operative visits using 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 evaluation and management visit they provide within the global period. This includes every facility visit (inpatient, outpatient, observation) as well as office visits.

The specified procedures have been identified as those that are furnished by more than 100 practitioners and are either nationally furnished more than 10,000 times annually or have more than $10 million in annual allowed charges. Please see below for a complete list of procedures that must follow the new guidelines.

When will post-operative reporting begin?

Beginning July 1, 2017, practitioners will need to report for each postoperative evaluation and management visit they provide within the global period for specified codes.

Why is it important to participate?

This is a mandatory policy. Currently there is no penalty for not participating, however, there is the possibility of future payments being withheld. It is important to report because incomplete reporting means incomplete and inaccurate data and can result in reduced global codes and values.

How will Plastic Surgeons be affected?

Plastic Surgeons who bill the following codes may be impacted:

CPT CodeDescription
11406 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm
11423 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm
11442 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm
11443 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm
11643 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm
11644 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm
13160 Secondary closure of surgical wound or dehiscence, extensive or complicated
14020 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less
14021 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm
14040 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less
14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less
14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm
15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
15240 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less
15732 Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter muscle, sternocleidomastoid, levator scapulae)
15734 Muscle, myocutaneous, or fasciocutaneous flap; trunk
19357 Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion

*For a complete list of all 293 codes that will follow new reporting guidelines, please click here.

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