E/M Coding Alert - 2019 Issue 2
Get A Handle on Global Periods When Considering Modifier 57
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Article Overview
This article explains the CMS global surgery framework in relation to modifier 57 and highlights how global period categories are organized for surgical services. It is aimed at coders, billers, and revenue cycle staff who need a general understanding of CMS guidance, global surgery booklet references, and the types of claim situations where global period concepts come into play.
Why This Topic Matters
Global period rules affect how surgical and evaluation-and-management services are reported around the time of a procedure. Understanding the CMS framework helps coding professionals recognize when global surgery concepts are relevant and where to look for official guidance.
Article Sections
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CMS Global Surgery Booklet Overview
Introduces the CMS guidance source used as the basis for the discussion. It frames the article around global surgery concepts and the broader Medicare context.
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10-Day Global Surgery Packages
Covers the CMS category for shorter global periods and summarizes the general structure of that package. An example is used to illustrate the type of procedure discussed in this category.
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90-Day Global Surgery Packages
Covers the CMS category for longer global periods and summarizes the general structure of that package. The section includes an example involving evaluation-and-management and a surgical procedure in the emergency department setting.
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Reminder on Major and Minor Surgery Categories
Provides a brief recap of how CMS groups procedures by global period length. The section reinforces the article’s focus on the relationship between global period categories and surgery types.
What You Will Learn
- How CMS organizes global surgery periods into general categories
- Where modifier 57 fits within the global surgery discussion
- What types of official CMS resources the article references
- How the article frames claim scenarios involving surgery and evaluation-and-management services
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Emergency department coding staff
- Surgical coding staff
Codes Discussed
Modifiers Discussed
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