Medicare Compliance & Reimbursement - 2022 Issue 2
Modifiers: Rely on Global Periods to Help Choose Appropriate Modifier
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Article Overview
This premium coding article reviews how global periods influence modifier selection for evaluation and management services, especially in situations involving postoperative care and same-day or day-before surgical decision-making. It is written for medical coders, billers, and documentation staff who need to understand when broad federal guidance, payer policies, and operative timing affect claim reporting. The article focuses on general guidance for using modifier-based reporting in relation to major procedures and postoperative periods without substituting for payer-specific rules or full coding references.
Why This Topic Matters
Choosing the wrong modifier in the context of a global period can affect claim accuracy and payment. This article helps readers understand the scope of postoperative and preoperative E/M services so they can review documentation and apply modifier-related guidance more confidently.
Article Sections
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Remember 90 Days for Post-Op Period
This section introduces how a 90-day global period affects postoperative evaluation and management reporting. It addresses the broader context for identifying when follow-up care may fall inside or outside the original procedure’s surgical package.
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Use Modifier 57 for Same-Day E/Ms, Surgeries
This section covers evaluation and management services that lead to a decision for surgery and the timing relationship to major procedures. It also references federal claims guidance and documentation considerations tied to major surgical periods.
What You Will Learn
- How global surgical periods influence modifier selection for evaluation and management services
- How to distinguish unrelated postoperative visits from surgery-related follow-up care
- How timing affects modifier use for visits that lead to major procedures
- Why documentation and payer guidance matter in modifier-based reporting
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Physician office staff
- Revenue cycle professionals
Modifiers Discussed
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