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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
Medicare guidance says, Medicare Global Surgery Rules define the rules for reporting evaluation and 
management (E&M) services with procedures covered by these rules. This section summarizes some of the 
rules. If a procedure has a global period of 000 or 010 days, it is defined as a minor surgical procedure. In 
general E&M services on the same date of service as the minor surgical procedure are included in the payment 
for the procedure. The decision to perform a minor surgical procedure is included in the payment for the minor 
surgical procedure and shall not be reported separately as an E&M service. However, a significant and 
separately identifiable E&M service unrelated to the decision to perform the minor surgical procedure is 
separately reportable with modifier 25. The E&M service and minor surgical procedure do not require different 
diagnoses. If a minor surgical procedure is performed on a new patient, the same rules for reporting E&M 
services apply. The fact that the patient is ?new ? to the provider is not sufficient alone to justify reporting an 
E&M service on the same date of service as a minor surgical procedure. NCCI contains many, but not all, 
possible edits based on these principles. You can find this guidance in the National Correct Initiative Policy 
Manual Chapter 1, D. Evaluation and Management (E&M) Services. Medicare guidance says, A. Relationship 
to Correct Coding Initiative (CCI)- The CCI policy and computer edits allow A/B MACs (B) to detect 
instances of fragmented billing for certain intra-operative services and other services furnished on the same day 
as the surgery that are considered to be components of the surgical procedure and, therefore, included in the 
global surgical fee. When both correct coding and global surgery edits apply to the same claim, A/B MACs (B) 
first apply the correct coding edits, then, apply the global surgery edits to the correctly coded services. A/B 
MACs (B) use the following evaluation and management codes in establishing edits for visits included in the 
global package. Evaluation and Management Codes for A/B MAC (B) Edits - 99213. You can find this 
guidance in the Medicare Claims Processing Manual Chapter 12 - Physicians/Nonphysician Practitioners, 40.3 
- Claims Review for Global Surgeries. 
 
Medicare guidance says, HCPCS 17000, Global days -010. You can find this guidance in the 2019 National 
Physician Fee Schedule Relative Value File Release. Medicare guidance says, Global Surgery This field 
provides the postoperative time frames that apply to payment for each surgical procedure or another indicator 
that describes the applicability of the global concept to the service; 010 = Minor procedure with preoperative 
relative values on the day of the procedure and postoperative relative values during a 10-day postoperative 
period included in the fee schedule amount; evaluation and management services on the day of the procedure 
and during this 10-day postoperative period generally not payable. You can find this guidance in the Medicare 
Claims Processing Manual Chapter 23 - Fee Schedule Administration and Coding Requirements, Addendum - 
MPFSDB Record Layouts 2019 File Layout. 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.