Reader Question: Global Period Drives Choice Between Modifiers 25 and 57

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article addresses a common coding question about choosing between two E/M-related modifiers when a physician provides an evaluation and a procedure on the same date of service. It focuses on the relationship between global periods and modifier selection, and includes brief claim examples involving office/outpatient evaluation services and minor versus major procedures. The piece is written for coders who need to understand the general decision context for same-day services and procedure-related billing.

Why This Topic Matters

Same-day E/M and procedure reporting can affect claim payment and compliance. Understanding the general distinction discussed in the article helps coders recognize when global-period rules may influence modifier selection.

Article Sections

  1. Question

    A reader asks for clarification about the difference between two E/M-related modifiers and when each is used.

  2. Answer

    The response discusses how procedure global days relate to same-day evaluation and procedure reporting, with separate discussion of minor and major procedure scenarios.

  3. Use modifier 25 when

    This section explains the general scenario involving an evaluation and a minor procedure on the same date, along with a brief illustrative claim example.

  4. Use modifier 57 when

    This section covers the general scenario involving an evaluation and a major procedure on the same date, along with a brief illustrative claim example.

What You Will Learn

  • How the article frames the relationship between global periods and same-day evaluation/procedure billing
  • The general situations discussed for selecting between two E/M-related modifiers
  • How brief claim examples are used to illustrate the article’s coding topic
  • Why modifier selection can matter when an evaluation and procedure occur on the same date

Who Should Read This

  • Professional coders
  • Physician billing staff
  • Practice managers
  • Revenue cycle staff

Codes Discussed

Code Ranges Discussed

  • CPT: 0- TO 10-DAY GLOBAL PERIOD
  • CPT: 90-DAY GLOBAL PERIOD

Modifiers Discussed


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