Understanding Surgical CPT Codes with Global Periods and Incidental Services
Many surgical procedures come with built-in post-operative care periods, known as global periods. Misunderstanding these global periods or billing for incidental services can lead to denials or audits. Here’s what you need to know to stay compliant.
What Are Global Days?
- 0-Day Global: Minor procedures (e.g., suture removal)
- 10-Day Global: Simple surgeries (e.g., lesion removal)
- 90-Day Global: Major surgeries (e.g., joint replacements)
What’s Included in Global Days?
- Pre-op visit (day before)
- Procedure
- Typical post-op care (follow-ups, bandaging, etc.)
Example Case: A surgeon performs a bunionectomy (CPT 28296), which includes a 90-day global period. During this time, routine post-op care and visits are included in the original reimbursement. Attempting to bill separately for a wound check within that period will trigger a denial unless there’s a significant, separately identifiable service documented and appended with a -24 modifier.
What Are Incidental Services? Incidental procedures are bundled into the main surgery and not billed separately (e.g., wound irrigation with suturing). CPT edits prevent separate billing unless modifiers (e.g., -59) are properly used with justification.
Workflow for Global Billing Compliance
| Step | Task | Solution |
| 1 | Identify CPT code & global days | Use CMS lookup tools |
| 2 | Avoid billing bundled/incidental services | Check NCCI edits |
| 3 | Use correct modifiers when applicable | Ensure documentation supports it |
| 4 | Track post-op visits | Prevent overbilling or duplication |
How We Help Our billing system automatically checks NCCI edits, flags bundled CPTs, and ensures global day compliance. We also provide support for appropriate modifier usage so you can avoid audits.
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