Global surgical package
Global surgical package: In a nutshell
- Each procedure code includes pre-, intra-, and post-service work that is considered part of that procedural code.
- The work included in the procedure cannot be reported and billed separately in an E/M service, even with modifier 25.
What is included in the pre-, intra-, and post-service work of some of the most frequently used codes in a derm practice?
Procedural code pre-, intra-, post-work includes the following for each code or codes listed.
Destruction codes (17000 & 17110)
Pre-work | Intra-work | Post-work |
|---|---|---|
Measure and document lesion/location Photo documentation of lesion Obtaining informed consent |
Inspecting and palpating lesions to determine diagnosis and specify size, location, and depth Destruction with liquid nitrogen freezing |
Applying antibiotic ointment and dressing (if needed) Providing patient and family with post-procedure patient instructions Charting Communication with the referring physician |
Skin biopsy codes (11102 – 11107)
Pre-work | Intra-work | Post-work |
|---|---|---|
Obtaining a pertinent medical history, including history of previous skin cancer, prior treatments, and sun protection Indications for performing the biopsy Reviewing expected benefits, description of procedure, and risks of the procedure with the patient Obtaining consent Preparing the biopsy tray |
Selecting the optimal biopsy site Inspecting and palpating the lesion Performing the biopsy procedure, from start to bandaging |
Providing patient instructions for care and follow-up Charting Communicating with the referring physician |
Malignant lesion destruction codes (17260 – 17286)
| Pre-work | Intra-work | Post-work |
|---|---|---|
Reviewing medical records and data Discussing treatment options and risks with the patient Obtaining informed consent Preparing the procedure tray |
Inspecting and palpating the lesion Noting the lesion’s size, location, functional risks, and depth Administering anesthetic Completing the procedure |
Applying antibiotic ointment and dressing Providing the patient with care and follow-up instructions Discussing recurrence risks and need for follow-up with the patient Charting Operative note reporting Communication with the referring physician |
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