decisionhealth Newsletters, Coder Pink Sheets - 2009 Issue 8 (August)
Back to the basics: Consider global period when using modifier 57
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Article Overview
This article explains a common coding topic involving evaluation and management services, surgical global periods, and when a modifier may be relevant to the initial decision for a major operation. It is aimed at coding and billing professionals who need a refresher on Medicare/global-period concepts and the difference between major and minor procedure timing. The discussion stays focused on broad use considerations, documentation context, and how this topic relates to another commonly confused modifier.
Why This Topic Matters
Understanding the relationship between the E/M visit, the surgical global period, and modifier use helps support accurate claim reporting and reduce denials when surgery is scheduled in close proximity to an office or hospital visit.
What You Will Learn
- How surgical global periods affect evaluation and management billing
- When a modifier may be relevant to the decision for a major surgery
- How major and minor procedure timing differs in the global period context
- Why this topic is often confused with another modifier used for E/M services
Who Should Read This
- Medical coders
- Billing staff
- Compliance staff
- Physician practice managers
Modifiers Discussed
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