Many procedures have either a 10- or 90-day postoperative global period. Generally, any care provided within that period is included in the payment for the procedure. However, there are some exceptions.
If a patient in a postoperative global period experiences a complication of the procedure for which they are in the global period and an evaluation and management (E&M) of that complication is performed, there is no modifier that allows for submission of that E&M. The only E&M modifier that can be used during a postoperative global period is the 24 Modifier which is only appropriate when an E&M service is performed for a problem unrelated to the procedure for which the patient is in the postoperative global period.
CPT 24 Modifier - Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period1.
If an unplanned procedure related to the procedure for which the patient is in the postoperative global period is performed, it may be submitted with the 78 Modifier only if it is performed in an operating/procedure room. Unplanned procedures related to the problem for which the patient is in a global period may not be submitted unless they are performed in an operating/procedure room.
CPT 78 Modifier - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period1.
If an unplanned procedure is performed that is not related to the procedure for which the patient is in the postoperative global period is performed, it may be submitted with the 79 Modifier, regardless of where the procedure is performed.
CPT 79 Modifier - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period1.
The 58 Modifier represents a procedure or service provided during the postoperative period that was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure.
CPT 58 Modifier - Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period.
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About the Author
Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC, CPMA is a podiatrist practicing in Fort Collins, CO and operates Lehrman Consulting, LLC which provides guidance regarding coding, compliance, and documentation. Dr. Lehrman is a Certified Professional Coder and Certified Professional Medical Auditor.
