Services Not Included in the Global Package of Major Surgeries
These services may be paid for separately. In some instances, you must use the appropriate modifier when billing for these services.
1. The initial consultation or evaluation of the problem by the surgeon to determine the need for surgery (57 modifier).
2. Visits unrelated to the diagnosis for which the surgic al procedure is performed unless the visits occur due to complications of the surgery (24 modifier).
3. Diagnostic tests and procedures, including diagnostic radiological procedures. No modifier is needed for x
– ray and lab procedures during the global period.
4. Clearly distinct surgical procedures during the postoperative period which are not reoperations or treatment for complications. (A new postoperative period begins with the subsequent procedure.) This includes procedures done in two or more parts for which the decision to stage the procedure are made prospectively or at the time of the first procedure. Examples of this are procedures to diagnose and treat epilepsy (codes 61533, 61534 -61536, 61539, 61541 and 61543), which may be performed in succession within 90 days of each other (58 modifier).
5. Critical care services (99291 and 99292) unrelated to the surgery where a seriously injured or burned patient is critically ill and requires constant attendance of the physician.
Anesthesia billing modifiers
Surgical billing modifiers
Medical billing process
