The typical global surgery period covers pre and post-operative care. However, if a patient requires additional care during the surgery period, possessing the correct modifier is important to avoid denials. Properly understanding the global period is important so that you know what can be billed and what cannot.
Below are some quick explanations of when these modifiers would correctly be used during the global surgery period.
- Modifier 57 – bill an E/M service that results in a decision to perform surgery on the day before or the day of a major surgery with a 90-day global period
- Modifier 24 – bill an E/M service that occurs within the post-operative period, but is not related to the original surgical procedure
- Modifiers 78 and 79 – bill for “unplanned” post-operative needs that may arise
- Modifier 58 – bill for a second procedure or services that occur during the post-operative period of an initial service, when you planned for the second procedure ahead of time
Denials can best be avoided when specific documentation is provided about the exact procedure.