How do you determine whether a code should be billed as global or separate?

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How to Determine Whether a Code Should Be Billed as Global or Separate

Tailored for Educational Students in our Medical Coding Course

In medical coding, understanding whether a service is part of the global surgical package—or must be billed separately—is critical for accuracy and reimbursement. The global period bundles all routine pre-operative, intra-operative, and post-operative care into one fee, depending on the procedure’s global indicator (0, 10, or 90 days).

Why this matters to students: Misbilling during the global period risks denials or audits. For example, routine follow-ups, dressing changes, and suture removals are included in the global fee.

However, exceptions exist. Use Modifier -25 for a significant, separately identifiable E/M service on the same day as the procedure. Use Modifier -24 for an unrelated E/M service during the postoperative period. Additionally, Modifier -57 is used when an E/M visit results in the decision for a major surgery on the day of or before it.

When care is split among providers (e.g., one performs surgery, another manages post-op care), billing may still be within the global package—but requires appropriate use of Modifiers -54, -55, or -56, and documentation of the transfer agreement. Recent updates include the 2025 HCPCS add-on code G0559, used when post-operative care is done by a practitioner other than the one who performed the surgery.

Quality Thought: Accurate use of modifiers and documentation reflects a commitment to coding integrity and Quality Thought—ensuring claims are precise and defensible.

As Medical Coding students, mastering these guidelines equips you to navigate global versus separate code scenarios confidently. Our courses at [Quality Thought} teach these nuances step-by-step, from identifying included services to applying modifiers and handling split care scenarios.

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