What is the global waiting period?

A global period refers to the time starting with surgical treatment and ending after the procedure. This period varies for each patient as it depends on the severity of the surgical treatment and the time of recovery for the patient.  During this time of recovery one cannot comprehend asking for fees for the more complex treatment from the patient, and hence the payment for the surgical procedure is bundled into the global surgery fee. The fee payment amount  includes all supplies and services that are a necessary part of that surgical procedure. However,  medical billing experts adhere to the terms and rules allied with Medicare and other insurances. The  Centers for Medicare and Medicaid Services have designated the global period to be followed by  other payers.  

Global waiting periods include preoperative, intraoperative & postoperative care, based on the global period. The time that begins is zero, 10, or 90 postoperative days. 

Stages of Global Waiting Period 

Preoperative Services: 

The reimbursement for a surgical treatment applies to payment for all E/M services provided in conjunction with a procedure. Preoperative services include: 

• A minor procedure, beginning 0-10 postoperative days, including the day of surgical procedure.
• A major surgical procedure beginning 90 postoperative days includes one day before and the day of surgery. In this scenario, Evaluation and Management (E/M) code is applicable for separate reimbursement with modifier-57. 

Intraoperative Services: 

The reimbursement for a surgical treatment applies to payment for usual, routine, and necessary services provided in conjunction with a procedure. 

Postoperative Services: 

The reimbursement for a surgical treatment applies to payment for all proficient services provided in conjunction with a procedure and during the postoperative period. They include : 

• Incision care or dressing changes 
• Post-op pain management furnished by the surgeon 
• E/M services, including physical history related to the decision for surgery
• Removal of casts, tubes, splints, drains, staples, and cutaneous sutures 
• Typical postoperative follow-up care, including immediate care related to that procedure that does not require any further operations
• Irrigation, removal of catheters, and insertion 
• Routine check-up related to recovery from postanesthesia  

Identified modifiers for providers involved in the surgical procedure 

• A qualified healthcare professional or surgeon, or physician who performs any stage of the  global waiting period (pre-, intra-, postoperative care) identified by modifiers -54, -55, -56
• For the assistant surgeon, the appropriate modifier is -80, -81, -82, and -AS 
• For two surgeons, the appropriate modifier is -62 
• For team surgeons, the appropriate modifier is -66 
• CRNA and anesthesiologists  

The experts at Capline ensure maximum reimbursement for the global period by using appropriate surgical codes and modifiers.