Global Period in Medical Billing - Complete Guide

The Centers for Medicare and Medicaid Services (CMS) billing reimbursement policy for a 90-day period. A global period is an extended period in which a patient stays at the hospital for recovery after surgery. All the procedures during this hospital stay are billed once in a single claim. It is a single payment and requires accurate claim processing to receive timely reimbursement. In addition, providers can outsource medical billing services for seamless claim processing.

What is the Global Period in Medical Billing?

The global period, also called global service, is when a patient undergoes surgery and stays in a hospital for post-surgery treatment. All the procedures and treatments during this long hospital stay are bundled to bill payers in a single claim. Likewise, this period lasts 0, 10, or 90 days. In addition, the physician doesn’t bill the patient or payer for every visit because all visits are billed once. Hence, a global surgical package is a single payment for all the services rendered during the hospital stay. This service includes:

Preoperative Services- Care provided the day before surgery.
Intra-Operative Services- The day of the procedure.
Postoperative Services – This includes follow-up care and recovery days after the procedure.

Types of Global Period in Medical Billing

The three surgical period services include simple, minor, and major procedures:

Zero Global Period-000

This period is the day of the procedure when a patient doesn’t have to stay in the hospital after the minor surgery. Endoscopic services are mostly included in this period. In addition, if the patient has to visit the physician’s office the same day regarding the procedure, it is not payable. The zero period doesn’t have a preoperative or postoperative period.

10-Day Global Period-010

This period begins on the day of the procedure and lasts up to 10 days. Likewise, this procedure doesn’t include preoperative service. It has postoperative service due to the care a patient needs after the surgery.

90-Day Global Period-090

It starts the day before the major surgery. It includes preoperative service because the physician has to observe the patient’s condition before the major surgical procedure. The period lasts 92 days: Day 1 is before the procedure, the next is the surgical day, and the remaining 90 days are for follow-ups. Thus, it has a total of 92 days, but CMS refers to it as 90 days.

Use of Suitable Modifiers

Submitting accurate claims is crucial to enhancing accounts receivable in medical billing. For this purpose, it is necessary to use accurate modifiers with the right service. The following modifiers are applicable to the global service package:

Modifier 24 applies to the unrelated evaluation and management (E/M) service.
Modifier 25 applies to the separate E/M encounter for minor surgery on the same day.
Modifier 57 applies when a physician decides to perform surgery during the initial E/M service.
Modifier 58 applies when a staged or planned procedure occurs during the postoperative period.
Modifier 78 applies to another related procedure performed during the postoperative procedure. This modifier is typically used for an emergency operation.
Modifier 79 applies when a physician performs an unrelated procedure during the postoperative period.

Conclusion

The zero, 10-day, and 90-day periods have different payment plans. In addition, use appropriate modifiers with the global period service. Likewise, it is crucial to bill the payer with accurate CPT codes and modifiers to receive timely reimbursements. It further enhances the claim processing. So, maximize your payments by submitting clean surgical claims.