What Is the Global Period in Medical Billing

1. What Is the Global Period in Medical Billing? Types, CPT Codes, & Modifiers Source: https://imedclaims.com/global-period-in-medical-billing/ The field of medical billing is complex, governed by a maze of rules and regulations that can feel overwhelming—even to seasoned professionals. One critical, yet often misunderstood concept is the global period. Understanding what the global period entails is essential for accurate claims submission, compliance, and proper reimbursement. This guide breaks down everything you need to know about the global period in medical billing—including its definition, types, associated CPT codes, and modifiers—while also offering insights into common pitfalls and best practices. What Is the Global Period in Medical Billing? The global period refers to a specific timeframe during which all necessary services related to a surgical procedure are considered part of a single global payment. This period includes:

2. Pre-operative services Intra-operative services Post-operative follow-up care These services are bundled together and not billed separately. The Centers for Medicare & Medicaid Services (CMS) defines the global period to ensure uniformity in surgical billing and prevent duplicate payments. Department of Labor Definition According to the U.S. Department of Labor: “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 postoperative care are bundled into the global surgery fee.” The OWCP (Office of Workers' Compensation Programs) states that no global period should exceed the duration established by CMS. Why Is the Global Period Important? The global period streamlines the reimbursement process and reduces administrative burden. It: Prevents duplicate billing of routine services. Helps insurers determine what is included in a surgical package. Encourages comprehensive, continuous care for patients. Offers clarity and transparency in medical billing. By bundling services, providers can avoid unnecessary claim rejections and focus on delivering quality care without worrying about individual billing for each post-op service. Types of Global Periods CMS has established three types of global periods, each associated with specific types of surgical procedures: 1. 0-Day Global Period

3. Covers services only on the day of the procedure. Any follow-up care after this date is billed separately. Common for minor procedures. Examples of CPT Codes: 10040– Acne surgery 11042– Debridement, subcutaneous tissue 2. 10-Day Global Period Includes the day of surgery and 10 days of routine post-operative care. Follow-ups within this window are bundled into the global fee. Examples of CPT Codes: 11401– Excision of benign skin lesion (0.6 to 1.0 cm) 12002– Simple repair of superficial wounds (2.6 to 7.5 cm) 3. 90-Day Global Period Includes the day before surgery, the surgery itself, and 90 days of follow-up care. Typically used for major surgical procedures. Examples of CPT Codes: 27447– Total knee arthroplasty 66984– Cataract surgery with intraocular lens Services Included in the Global Surgical Package CMS and AMA guidelines categorize the global package into three key components: 1. Pre-operative Services Consultation one day prior (for major procedures) Same-day evaluation (for minor procedures) Confirmation of surgical decision

4. 2. Intra-operative Services The actual surgical procedure Anesthesia (if performed by the surgeon) Wound closure and hemostasis Assistance by surgical team 3. Post-operative Services Follow-up visits Wound care and dressing changes Removal of sutures, staples, splints, or tubes Monitoring vital signs and recovery Pain management and treatment of minor complications ⚠️Note: All these services are non-billable separately if performed within the global period for the same surgical episode. Services Not Included in the Global Period Certain services are excluded from the global package and can be billed separately. These include: Unrelated Evaluation & Management (E/M) visits Treatment for unrelated conditions Emergency care not related to the surgery Unplanned or staged procedures Complications requiring return to the OR Appropriate modifiers must be used to flag these exceptions. Global Period Modifiers Correct modifier usage is essential to differentiate services outside the global package. Below are the most common ones: Modifier 24 25 Use Case Unrelated E/M service by the same physician during the post-op period Significant, separately identifiable E/M service on the same day as the procedure

5. 57 58 78 79 Decision for surgery made during E/M visit (applies to major surgeries) Staged or planned procedure during the post-op period Unplanned return to the OR for related procedure during post-op Unrelated procedure or service during the post-op period Incorrect or missing modifiers are a leading cause of claim denials in surgical billing. Common Global Period Billing Errors & How to Avoid Them Here are frequent errors practices make—and how to correct them: Error Solution Billing follow-up visits separately Failing to append modifiers Billing related procedures as separate events Misunderstanding timing of global periods Understand what’s included in the global package Use the correct modifier for exceptions (e.g., 24, 79) Consolidate services under the correct CPT code Check CMS Physician Fee Schedule for accurate global period assignment Benefits of the Global Period for Providers & Patients ✅ ✅ For Providers: Fewer claim denials Easier revenue cycle management Less administrative workload Streamlined documentation Enhanced compliance ✅ ✅ For Patients: Clear understanding of costs Fewer unexpected bills Encouragement to attend follow-up visits Enhanced satisfaction and trust in care How to Verify a Procedure’s Global Period

6. To verify the global period for a particular CPT code: 1.Visit the CMS Physician Fee Schedule Lookup Tool. 2.Enter the CPT code. 3.Review the “Global Days” column. Conclusion Understanding and applying the global period in medical billing is not just about avoiding denials—it's about ensuring a compliant, transparent, and patient-centered healthcare experience. From knowing which CPT codes fall under which category to accurately appending modifiers for exceptions, mastering the global period framework is essential for every healthcare billing team. By adopting best practices and maintaining up-to-date knowledge, medical practices can reduce errors, secure proper reimbursement, and build long-term patient trust.