Major surgical procedures (90-day global period) : There is one day of preoperative care so the global period starts the day prior to the surgery. Care on the day of the surgery is included in the global period unless the decision to perform the surgery was made during the visit on this day. There are 92 days in the global surgical period beginning the day before the procedure, the day of the procedure, and the 90 days following it.
Services rendered during this period may include, but not be limited to the following: One preoperative visit, unless the decision to perform major surgery was made during the visit on the day of the surgery. If the decision to perform surgery was made the same day as the surgery was performed then append modifier -57 to the appropriate level of EM service for proper reimbursement.
Intra-operative care including the performance of the surgery.
Postoperative Care: All standard postoperative care of the patient including but not limited to removal of sutures, staples, casts, drains, tubes, packs, etc. Any wound care or dressing changes. Any care required of the surgeon due to postoperative complications or problems that do not require the patient to be taken back to the operating room for further procedures.
Supplies used to treat any postoperative surgical complications or treatments, unless otherwise stated as exclusive.
If the patient must be returned to the operating room for surgery for a procedure that is staged then this must be reported with modifier -58. If the procedure is unrelated, then modifier -79 would be reported. If there is an unplanned return to the operating room for a related procedure (by the performing physician) then -78 would be appended.
Post-operative pain management.
Office visits related to the recovery from the surgical procedure.
Office visits related to complications that arose from the surgical procedure.
