Ophthalmic Coding Specialist Practice Test

Is it possible to bill for laser procedures on an eye within the global period after previous procedures?

1. Yes

2. No

3. Only with prior approval

4. Yes, within 30 days

The correct answer is: No

Billing for laser procedures on an eye within the global period after previous procedures typically is not allowed. The global period is established to encompass the time during which all related services are included in the payment for the initial procedure. This is designed to prevent duplicate payments for services that are essentially part of the recovery and follow-up care associated with a surgical or interventional procedure. In general, when a procedure falls within its designated global period, any additional treatments that are performed related to that procedure are considered included in the initial payment for that procedure. Therefore, billing for a new laser procedure in this timeframe would usually be inappropriate unless a specific exception applies, such as a significant complication requiring separate treatment. While there are certain scenarios, such as complications or distinct medical necessity, where prior approval might allow for separate billing, this does not universally apply and typically requires evidence that the extensive care required falls outside the scope of the global period coverage. Hence, the standard response is that additional procedures cannot be billed during this time, corroborating the selected answer.