Medicare Global Surgical Package for Physicians and Hospitals: Today and the Future

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

Medicare GSP for Use with the MPFS and RBRVS, Impact of NCCI Coding Policy, GSP Phase Out and More!

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 phase out without unduly impacting physicians?

Join expert speaker Duane C. Abbey, Ph.D. in this 90-minute session to get answers to the following questions:

  • 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?
  • Is this package the same for physicians and hospitals?
  • How should physicians handle post-operative care relative to hospitalists?
  • Are E/M services always bundled into surgical services?
  • How should physician handle transfer of post-operative care?
  • Should physicians be using the “-54” modifier?
  • Does is the “-57” modifier used by physicians? By hospitals?
  • How do the NCCI Coding Policy directives affect the GSP?
  • Is there a GSP for DRGs?
  • Is there a GSP for APCs?
  • What about private payer GSPs?
  • What services should be bundled into 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?

Session Highlights:

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

Session Agenda:

  • 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
    • Potential Impact on Physicians
  • Sources for Further Information

Who should attend?

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

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
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