Document 'Unrelated' for Modifier 79 Services

Why This Topic Matters

Global-period billing can trigger payer review, and this article addresses why claims reported with modifier 79 may receive extra attention. It is relevant for organizations trying to keep surgical billing documentation aligned with Medicare contractor expectations and avoid improper reporting.

Article Sections

1. Obey Global Package Model

   This section introduces the global surgical package concept and describes the kinds of services generally associated with it. It frames the context for understanding when a separate service is discussed during the postoperative period.

2. Choose 79 for Distinct Procedure During Global Period

   This section discusses the use of modifier 79 in the setting of a separate service reported during an existing global period. It includes a broad example scenario and references documentation considerations.

3. Scrutinize Your 79 Claims -- Before Your Contractor Does

   This section addresses increased oversight of claims reported with modifier 79 and references CMS contractor review activity. It also mentions program safeguard concerns and a supporting CMS resource.

4. Distinguish Other Global Period Modifiers

   This section compares modifier 79 with other global-period modifiers and discusses how different postoperative situations are grouped at a high level. It also touches on the operating-room context associated with related global-period reporting.