Global periods are important to know because you will not get reimbursed during a global period if you do any work related to the original procedure. However, even if you do an unrelated procedure during the global period, you still won’t get reimbursed until you use modifier 79. Therefore, it is essential to know the global periods so that you can appropriately use modifier 79.
In this issue, we will concentrate on global periods for most commonly used procedure codes in dermatology. First, let’s take a look at procedures with no global periods. If there is no global period, that means that you will get reimbursed even the next day for anything related to the original procedure. Therefore, you don’t need to use modifier 79 with these codes. Most of the skin biopsies and Mohs codes without closures have no global period — or 0 days. However, some site-specific biopsy codes have global period of 10 days.
All destruction codes have global periods of 10 days.
Destruction of all malignant lesions by any method has a global period of 10 days.
All excision codes for malignant or benign lesions have 10 days of global period.
All simple, intermediate and complex repairs have 10 days global period.
All adjacent tissue transfers/rearrangements and grafts have 90 days global period.
Let’s Take a Look at Some Examples
Example I. Patient presents with a couple of actinic keratosis on his face and you go ahead and freeze them (CPT code 17000, 17003, or 17004, depending on how many you treat.) The same patient comes back 7 days later, and he says he forgot to show you the big nodule on his back that you think is a skin cancer and you biopsy it. How do you need to bill?
Use 11000 (skin biopsy) modifier 79 since you are still in the 10-day global period for CPT 17000, 17003, or 17004 (Cryosurgery for Actinic Keratosis).
Example II. Reverse example I, so that first you biopsy the lesion, then 7 days later, freeze the actinic keratosis. You don’t need modifier 79 for 17000 codes since 11100 code has 0 global period.
Example III. Patient in example I returns with an infected wound on one of the areas that you froze 9 days after the patient’s first visit. You treat the patient, and since this is related to your original work and it’s within 10 days, you shouldn’t charge for an office visit.
Example IV. Patient in example III returns in 11 days. You can charge for an office visit even though it’s related to the original work but is after the global period.
Example V. Patient in example I returns with an eruption on his back 9 days after the first visit, and you diagnose dermatitis and treat him. You can charge for an office visit, but you need to use modifier 24 to indicate this was not related to the original work that you did.
Points to Remember
Remember, modifier 24 always follows E&M codes and 79 always follows procedure codes within a global period. Global periods become even more important after grafts and flaps because they have 90-day global periods, and usually we will end up seeing these patients within 90 days to perform another procedure or E&M unrelated to the original work. It’s important for us to use either 79 or 24 modifiers, or else our claims will be automatically ejected.
Global periods are important to know because you will not get reimbursed during a global period if you do any work related to the original procedure. However, even if you do an unrelated procedure during the global period, you still won’t get reimbursed until you use modifier 79. Therefore, it is essential to know the global periods so that you can appropriately use modifier 79.
In this issue, we will concentrate on global periods for most commonly used procedure codes in dermatology. First, let’s take a look at procedures with no global periods. If there is no global period, that means that you will get reimbursed even the next day for anything related to the original procedure. Therefore, you don’t need to use modifier 79 with these codes. Most of the skin biopsies and Mohs codes without closures have no global period — or 0 days. However, some site-specific biopsy codes have global period of 10 days.
All destruction codes have global periods of 10 days.
Destruction of all malignant lesions by any method has a global period of 10 days.
All excision codes for malignant or benign lesions have 10 days of global period.
All simple, intermediate and complex repairs have 10 days global period.
All adjacent tissue transfers/rearrangements and grafts have 90 days global period.
Let’s Take a Look at Some Examples
Example I. Patient presents with a couple of actinic keratosis on his face and you go ahead and freeze them (CPT code 17000, 17003, or 17004, depending on how many you treat.) The same patient comes back 7 days later, and he says he forgot to show you the big nodule on his back that you think is a skin cancer and you biopsy it. How do you need to bill?
Use 11000 (skin biopsy) modifier 79 since you are still in the 10-day global period for CPT 17000, 17003, or 17004 (Cryosurgery for Actinic Keratosis).
Example II. Reverse example I, so that first you biopsy the lesion, then 7 days later, freeze the actinic keratosis. You don’t need modifier 79 for 17000 codes since 11100 code has 0 global period.
Example III. Patient in example I returns with an infected wound on one of the areas that you froze 9 days after the patient’s first visit. You treat the patient, and since this is related to your original work and it’s within 10 days, you shouldn’t charge for an office visit.
Example IV. Patient in example III returns in 11 days. You can charge for an office visit even though it’s related to the original work but is after the global period.
Example V. Patient in example I returns with an eruption on his back 9 days after the first visit, and you diagnose dermatitis and treat him. You can charge for an office visit, but you need to use modifier 24 to indicate this was not related to the original work that you did.
Points to Remember
Remember, modifier 24 always follows E&M codes and 79 always follows procedure codes within a global period. Global periods become even more important after grafts and flaps because they have 90-day global periods, and usually we will end up seeing these patients within 90 days to perform another procedure or E&M unrelated to the original work. It’s important for us to use either 79 or 24 modifiers, or else our claims will be automatically ejected.
Global periods are important to know because you will not get reimbursed during a global period if you do any work related to the original procedure. However, even if you do an unrelated procedure during the global period, you still won’t get reimbursed until you use modifier 79. Therefore, it is essential to know the global periods so that you can appropriately use modifier 79.
In this issue, we will concentrate on global periods for most commonly used procedure codes in dermatology. First, let’s take a look at procedures with no global periods. If there is no global period, that means that you will get reimbursed even the next day for anything related to the original procedure. Therefore, you don’t need to use modifier 79 with these codes. Most of the skin biopsies and Mohs codes without closures have no global period — or 0 days. However, some site-specific biopsy codes have global period of 10 days.
All destruction codes have global periods of 10 days.
Destruction of all malignant lesions by any method has a global period of 10 days.
All excision codes for malignant or benign lesions have 10 days of global period.
All simple, intermediate and complex repairs have 10 days global period.
All adjacent tissue transfers/rearrangements and grafts have 90 days global period.
Let’s Take a Look at Some Examples
Example I. Patient presents with a couple of actinic keratosis on his face and you go ahead and freeze them (CPT code 17000, 17003, or 17004, depending on how many you treat.) The same patient comes back 7 days later, and he says he forgot to show you the big nodule on his back that you think is a skin cancer and you biopsy it. How do you need to bill?
Use 11000 (skin biopsy) modifier 79 since you are still in the 10-day global period for CPT 17000, 17003, or 17004 (Cryosurgery for Actinic Keratosis).
Example II. Reverse example I, so that first you biopsy the lesion, then 7 days later, freeze the actinic keratosis. You don’t need modifier 79 for 17000 codes since 11100 code has 0 global period.
Example III. Patient in example I returns with an infected wound on one of the areas that you froze 9 days after the patient’s first visit. You treat the patient, and since this is related to your original work and it’s within 10 days, you shouldn’t charge for an office visit.
Example IV. Patient in example III returns in 11 days. You can charge for an office visit even though it’s related to the original work but is after the global period.
Example V. Patient in example I returns with an eruption on his back 9 days after the first visit, and you diagnose dermatitis and treat him. You can charge for an office visit, but you need to use modifier 24 to indicate this was not related to the original work that you did.
Points to Remember
Remember, modifier 24 always follows E&M codes and 79 always follows procedure codes within a global period. Global periods become even more important after grafts and flaps because they have 90-day global periods, and usually we will end up seeing these patients within 90 days to perform another procedure or E&M unrelated to the original work. It’s important for us to use either 79 or 24 modifiers, or else our claims will be automatically ejected.
