Description

The Global Surgical Package (GSP) for the Medicare program has long been an issue for physicians relative to proper coding, billing and maintaining compliance. To fully understand the GSP and then properly using the modifiers that go along with the GSP requires significant understanding and study.  Additionally, proper processes and procedures must be put into place to perform compliant coding and billing.  The RBRVS (Resource-Based Relative Value Scale) is also affected by the GSP in that pre-operative, intra-operative and post-operative segments must be separated for payment purposes.  Over the past several years CMS has realized that there are significant issues with proper coding under the GSP.  CMS has decided to phase out the GSP although this change will require significant study and analysis on the part of CMS.  The big question is how can the GSP be phased out without unduly impacting physicians?

• What is this Global Surgical package concept?
• For Medicare, is this not a Global Surgeon Package?
• How is the global surgical package (GSP) supposed to work?
• How should physicians handle post-operative care relative to hospitalists?
• Are E/M services always bundled into surgical services?
• How should the physicians handle the transfer of post-operative care?
• Should physicians be using the “-54” modifier?
• What do the NCCI Coding Policy directives affect the GSP?
• What about private payer GSPs?
• What services should be bundled into the surgical payment?
• How Is CMS changing the MPFS GSP?
• What must CMS do to phase out the GSP?
• How long will it take to phase out the GSP?
• What data must CMS collect in order to phase-out the GSP?
• What challenges must CMS overcome to eliminate the GSP?

Webinar Objectives:-

• To review the general concept of a global surgical package (GSP).
• To review the Medicare GSP for Use with the Medicare Physician Fee Schedule.
• To appreciate how GSPs evolve over time.
• To understand the National Correct Coding Initiative (NCCI) policy pronouncements for the GSP.
• To provide examples and case studies on coding for physicians relative to the Medicare GSP.
• To review the global surgical concept for APCs (Ambulatory Payment Classifications).
• To review the global surgical concept for MS-DRGs (Medicare Severity Diagnosis Related Groups)
• To assess how private third-party payers use the global surgical concept.
• To understand the many different ways that the Medicare program bundles or packages services relative to surgeries.
• To understand the proper use of the “-54”, “-55”, and “-56” modifiers.
• To appreciate associated processes such as the use of the “-25” and “-59” modifiers.
• To understand how CMS is in the process of phasing out the GSP.
• To appreciate what CMS must accomplish in order to make certain that physicians are not unduly affected by the phase-out.
• To appreciate the data that must be collected in order to phase-out the GSP.
• To understand the challenges that CMS faces in phasing-out the GSP.

Webinar Outline:-

• Global Surgical Package Concept
  • Blanket Payment for Surgery
  • Surgeon Orientation vs. Surgery Orientation
  • Associated Anesthesia Package
  • Variations In GSPs
• Medicare GPS for MPFS
  • Pre-Operative Period and Services
  • Intra-Operative Period and Services
  • Post-Operative Period and Services
    • 0-Day
    • 10-Day
    • 90-Day
  • In-Hospital Post-Operative Care vs. Post-Discharge Care
  • “-54”, “-55” and “-56” Modifiers
  • Indicators within the MPFS
  • Transfer of Care for Post-Operative Services
  • NCCI Edit Policy Manual Directives
  • Anesthesia Package Concept
  • Case Studies and Examples
• Related Surgical Packaging in Other Payment Systems
  • MS-DRGs – Pre-Admission Window
  • APCs – Surgical Packaging
  • Private Third-Party Payer Use of GSPs
  • Compliance Concerns
• CMS Phase-Out of GSP
  • CMS Activities in Preparation for Phase-Out
  • Relative Value Adjustments for Surgeries
  • Data Collection for Pre- and Post-Surgical Services
  • Factoring In the Current Misuse of the GSP
  • Potential Impact on Physicians
• Sources for Further Information

Prerequisites for Participating:- 

General knowledge of coding billing and reimbursement.

Suggested Attendees:- 

• Physician Coding Personnel
• Billing and Claims Transaction Personnel
• Chargemaster Coordinators
• Utilization Review Personnel
• Financial Analysts
• Compliance Personnel
• Physicians
• Internal Auditing Staff and
• Other Interested Personnel