{"id":14311,"date":"2021-09-24T14:51:34","date_gmt":"2021-09-24T14:51:34","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=14311"},"modified":"2025-06-03T11:29:19","modified_gmt":"2025-06-03T11:29:19","slug":"billing-guidelines-for-global-surgery-modifiers","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/billing-guidelines-for-global-surgery-modifiers\/","title":{"rendered":"Billing Guidelines for Global Surgery Modifiers"},"content":{"rendered":"

The global surgical package, also called global surgery, includes all the necessary services normally furnished by a surgeon before, during, and after a procedure. Medicare payment for a surgical procedure includes the pre-operative, intra-operative, and post-operative services routinely performed by the surgeon or by members of the same group with the same specialty. <\/span><\/p>\n

Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician. Use following billing guidelines for global surgery modifiers, as these modifiers are used by physicians to indicate a billed service is not part of a global surgical package and is eligible for separate reimbursement.\u00a0<\/span><\/p>\n

Use the Following Billing Guidelines for Global Surgery Modifiers<\/span><\/h2>\n

Modifier \u2018-24\u2019<\/span><\/h3>\n

Unrelated E\/M service by the same physician during a postoperative period. The physician may need to indicate that an E\/M service was furnished during the post-operative period of an unrelated procedure. An E\/M service billed with modifier \u2018-24\u2019 must be accompanied by documentation that supports that the service is not related to the post-operative care of the procedure. <\/span><\/p>\n

In order for the evaluation and management service to be payable in the post-operative period with the modifier \u2018-24\u2019, the diagnosis code supporting the E\/M service must be different from the diagnosis code reported for the previously performed surgery.<\/span><\/p>\n

Modifier \u2018-25\u2019<\/span><\/h3>\n

Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure or other service. The initial evaluation for minor surgical procedures and endoscopies is always included in the global surgery package. <\/span><\/p>\n

Visits by the same physician on the same day as minor surgery or endoscopy are included in the global package, unless a significant, separately identifiable service is also performed. Modifier \u2018-25\u2019 is used to bill a separately identifiable evaluation and management (E\/M) service by the same physician on the same day of the procedure.<\/span><\/p>\n

Modifier \u2018-57\u2019<\/span><\/h3>\n

An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E\/M service. E\/M services on the day before or on the day of major surgery (90-day global period) which result in the initial decision to perform the surgery are not included in the global surgery payment. These E\/M services may be billed separately and identified with the modifier 57.<\/span><\/p>\n

This modifier should not be used for visits furnished during the global period of minor procedures (0- or 10-day global period) unless the purpose of the visit is a decision for major surgery. This modifier is not used with minor surgeries because the global period for minor surgeries does not include the day prior to the surgery. When the decision to perform the minor procedure is typically done immediately before the service, it is considered a routine preoperative service, and a visit or consultation is not billed in addition to the procedure.<\/span><\/p>\n

Modifier \u2018-58\u2019<\/span><\/h3>\n

A staged or related procedure or service by the same physician during the post-operative period was established to facilitate billing of staged or related surgical procedures done during the post-operative period of the first procedure. Modifier \u2018-58\u2019 may be reported with the staged procedure\u2019s CPT. <\/span><\/p>\n

A new postoperative period begins when the next procedure in the series is billed. Modifier \u2018-58\u2019 indicates that the performance of a procedure or service during the postoperative period was:\u00a0<\/span><\/p>\n