Many wound care-related procedures, including some amputations and certain incision and drainage services carry with them a 10- or 90-day postoperative global period. For most third-party payers, any care provided within that global period is included in the payment for the procedure and should not be separately submitted. However, there are some exceptions.
Unrelated Evaluation and Management (E&M) services
The 24 Modifier may be appended to the CPT® code for an evaluation and management (E&M) addressing a problem that is unrelated to the one for which the patient is in a postoperative global period. As the 24 Modifier requires addressing a problem that is unrelated to the one for which the patient is in a postoperative global period, it is inappropriate to use this modifier when addressing a complication of the procedure for which the patient is in the global period.
If a related, unplanned procedure is performed during a postoperative global period, it can be submitted for payment if it was performed in an operating / procedure room. This is represented by appending a 78 modifier to the CPT code. Procedures related to the problem for which the patient is in a postoperative global period (even a debridement of an unplanned, postoperative complication) should not be submitted if not performed in an operating / procedure room.
The 79 Modifier may be used for procedures unrelated to the problem for which the patient is in a postoperative global period without consideration of the place of service.
The 58 modifier may be used for procedures during the global period that are planned or anticipated (staged), more extensive than the original procedure, or for therapy following a surgical procedure. Where the procedure takes place does not play a role in 58 Modifier use eligibility.
2022 CPT Professional. Current Procedural Terminology (CPT®) is copyright 1966, 1970, 1973, 1977, 1981, 1983-2021 by the American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
National Correct Coding Initiative Policy Manual For Medicare Services