What is the definition of a major surgical procedure in the context of Medicare?

In the context of Medicare, a major surgical procedure is defined as one that includes a one-day preoperative period and a 90-day postoperative period. This definition is important for understanding the billing and reimbursement processes associated with surgical services. The one-day preoperative period allows for certain preparations and evaluations prior to the surgery, while the 90-day postoperative period includes coverage for any follow-up care or complications that may arise as a result of the procedure.

This classification is essential for ensuring that both providers and patients understand the extent of care that is included in the total costs associated with major surgeries. Proper coding and documentation during these delineated timeframes are crucial for compliance and accurate reimbursement.

Other options do not meet the established criteria for what constitutes a major surgical procedure under Medicare's guidelines. For example, a procedure with a 0-day preoperative and a 10-day postoperative period describes a minor surgical procedure rather than a major one. Likewise, emergency services can be complex and involve different billing protocols, while procedures with no defined postoperative period typically do not fall under the major surgical procedure category and are instead classified as minor or non-surgical interventions.