Reader Questions: Look to Global for Modifier Success

Why This Topic Matters

Understanding global surgical periods is important for correct claim reporting, avoiding unbundling concerns, and supporting separate reporting of evaluation and management services when permitted by the applicable rules. The article highlights the broader issue of how procedure global periods influence modifier selection and documentation review.

Article Sections

1. Question

   A reader asks about reporting an outpatient evaluation and management service performed on the same day as a procedure and whether a modifier is needed to separate the services.

2. Answer

   The response discusses separate reporting of the visit and procedure, with reference to global surgical periods and the related modifier selection context.

3. Why 25?

   This section explains the general relationship between global surgical periods and modifier use for same-day services, including how global period length affects reporting considerations.

4. There is another option for other circumstances, though.

   The article notes that a different modifier may be relevant in other surgical scenarios involving a longer global period.

5. Best bet

   The closing guidance points readers to Medicare Physician Fee Schedule resources for reviewing global period information tied to CPT codes.