Michael F. Easley, Governor Buck Lattimore, Chairman |
Bernadine S. Ballance,
Commissioner Thomas J. Bolch, Commissioner Laura K. Mavretic, Commissioner Renée C. Riggsbee, Commissioner Christopher Scott, Commissioner Dianne C. Sellers, Commissioner |
North Carolina
Industrial Commission
MEMORANDUM
TO: | All
Workers’ Compensation Carriers, Third Party Administrators, Self-Insured
Employers and Medical Bill Processors; and All Workers’ Compensation
Medical/Surgery Providers |
FROM: | Jennifer
Gudac, Chief Medical Fee Examiner |
DATE: | June 21, 2002 |
SUBJECT: | Surgery Fees and Proper Guidelines for Applying the Global Period |
This
memo is to clarify the North Carolina Industrial Commission Medical Fee Schedule
guidelines to surgical global fees. The surgical global period includes the
actual surgery and any hospital or office visits related to uncomplicated
follow-up care for the surgery within the global time limit. The surgical global
period does not include postoperative complications (i.e., bleeding or
infections) or unrelated services (i.e., services by another specialty).
Medical
bill processors should exercise caution when using the global period to deny
charges, especially when processing bills from larger provider heath centers
that are rendering medical services from multiple specialties.
Attention
to modifiers used by the providers will help identify complications and
unrelated services, and ensure that providers are reimbursed for these services.