Does modifier 58 start a new global period?
Asked by: Eveline Hyatt | Last update: May 25, 2025Score: 4.1/5 (15 votes)
Does modifier 58 restart global period?
Within the 90-day global period, the tear progresses to an RD, requiring vitrectomy RD repair (CPT 67108). In this case, “more extensive” also applies. Modifier –58 reimburses the surgeon based on 100 percent of the allowed amount and restarts the global period (as long as it exceeds the first global period).
What modifier to use for global period?
E/M services that are eligible for payment during the global period include any services that meet the criteria for use with modifier –24, –25, or –57. Modifier –24 is appended to an E/M service during the global period to indicate that the E/M service was unrelated to the surgery.
What is the proper use of modifier 58?
To start, modifier 58 is a surgical-specific modifier, used to indicate a staged or related procedure or service by the same physician during the postoperative period.
Which scenario qualifies for modifier 58?
Modifier 58 is defined as a staged or related procedure performed during the postoperative period of the first procedure by the same physician. A new postoperative period begins when the staged procedure is billed.
CPC/CPB Practice Exam Review: Modifiers
What is the global period?
A global period is a period of time starting with a surgical procedure and ending some period of time after the procedure. Many surgeries have a follow-up period during which charges for normal post- operative care are bundled into the global surgery fee.
Can modifier 58 and 82 be billed together?
This modifier should be removed and the service(s) resubmitted with HCPCS modifier AS or CPT modifier 80, 81 or 82. It is generally not appropriate to submit CPT modifier 58 with these CPT codes.
What is the global period modifier 24?
Use CPT modifier 24 for unrelated evaluation and management service during a postoperative (global) period. The global period of a major surgery is the day prior to, day of and 90 days after the surgery.
What is the Medicare Code 58?
Denial code 58 is used when the payer determines that the treatment or service was provided in a location that is considered inappropriate or invalid according to their guidelines.
What is the correct use of a modifier?
Always place modifiers as close as possible to the words they modify. When you place modifiers too far away from the words that they modify, you change the meaning of the sentence, creating what is called a misplaced modifier error.
What is CPT global period?
Global Period
A period of time starting with the pre-operative period of a surgical procedure and ending some period of time after the procedure was performed. Centers for Medicare & Medicaid (CMS) global surgery indicators are found in the CMS National Physician Fee Schedule Relative Value Files.
Does the global period start over with modifier 78?
Modifier 78 (Unplanned Return To The Operating/Procedure Room By The Same Physician Or Other Qualified Health Care Professional Following Initial Procedure For A Related Procedure During The Postoperative Period) does not restart the global period, and will be subject to a reduction in reimbursement for the portion of ...
What is the generally accepted global period considered to be for major procedures?
If a procedure has a global period of 090 days, it is defined as a major surgical procedure. If an E&M service is performed on the same date of service as a major surgical procedure to decide whether to perform this surgical procedure, the E&M service is separately reportable with modifier 57.
What modifier is used during the global period?
A new global period begins with each subsequent procedure, and usually there is no reduction in reimbursement. Modifier 58 may be used during the global surgical period for the original procedure only.
Can you bill an office visit with a cast application?
A charge for procedure codes 29000-29590 is allowed only when the casting or strapping is a replacement procedure used during the period of follow-up care. The charge for an office visit is allowed only if significant identifiable further services are provided at the time of the cast application or strapping.
What is the global period for laceration repair?
The laceration repair codes-12001-13153-have a 10-day global period, and the codes already include the suture removal.
What is modifier 58 global period?
Post-Operative Period
Modifier –58 (Staged or related procedure or service by the same provider during the post-operative. period) helps bill staged or related surgical procedures during the first post-operative period procedure.
What is the 30 day rule for Medicare?
You must enter the SNF within a short time (generally 30 days) of leaving the hospital and require skilled services related to your hospital stay. After you leave the SNF, if you re-enter the same or another SNF within 30 days, you don't need another 3-day qualifying hospital stay to get additional SNF benefits.
What is authorization code 58?
58 – Transaction not permitted - Terminal
This code will appear if you are attempting a transaction and your merchant processing account is not properly configured. Contact your merchant provider and make sure your terminal/POS is set up to receive the type of payment you're attempting.
What procedures have a 10 day global period?
Minor procedures have a global period of 10 or 0 days. The global period includes Evaluation and Management (E/M) services that are related to the procedure.
What is the global period for modifier 57?
CPT modifier 57 may be used to report the decision for surgery for certain codes. This modifier may be used to indicate that an evaluation and management (E/M) service performed on the same day or the day before a major surgery (090 global days) by the surgeon resulted in the decision to perform the procedure.
What is the global period modifier 25?
Modifier 25 may be appended to E/M services reported with minor surgical procedures (i.e., 0- day and 10-day global periods) or procedures not covered by a global period (i.e., XXX).
What is the global period for Medicare?
Medicare defines the global period as that period of time during which a physician may not bill for related office visits. The global period may be 90, 10, or 0 days. According to Medicare, a major surgery has a global period of 90 days, and a minor surgery has a global period of either 10 or 0 days.
Which modifiers go first?
The payment modifier should be placed first and then any informational modifiers follow. A payment modifier example is -58, -79. These modifiers tell the payer why a surgery should be paid a certain way.
What is the global period for a colonoscopy?
Colonoscopy services are assigned a “000-day” global period. Chapter 6 of the National Correct Coding Initiative manual states, “If a procedure has a global period of 000 or 010 days, it is defined as a minor surgical procedure.