DENIAL PLAYBOOK · GLOBAL SURGERY PERIOD (E/M DURING GLOBAL)

How to appeal a Global Surgery Period (E/M During Global) denial

This denial bundles an office visit into a procedure's global surgical period, treating it as included post-op care, even when it was a separate, billable service.

Common code: CARC 97 (E/M bundled into the global surgical period)

Why payers issue it

The visit fell in the 10- or 90-day global window and was auto-bundled
A distinct-service modifier (24, 57, or 79) was missing or unsupported
An unrelated visit was coded like routine follow-up
The decision-for-surgery visit wasn't flagged with modifier 57

What overturns it

Append the correct modifier: 24 for an unrelated E/M in the global period, 57 for the decision for surgery, or 79 for an unrelated procedure
Document that the visit was unrelated to the surgery or was the decision-making encounter
Tie the note directly to the modifier used
Show the diagnosis distinguishing the visit from post-op care

Worth appealing? Global-period bundling hides real E/M work inside the surgical fee, the right modifier plus a note proving the visit was separate is what recovers it.

Common questions

How do I appeal a Global Surgery Period (E/M During Global) denial?

This denial bundles an office visit into a procedure's global surgical period, treating it as included post-op care, even when it was a separate, billable service. To overturn it: append the correct modifier: 24 for an unrelated E/M in the global period, 57 for the decision for surgery, or 79 for an unrelated procedure; document that the visit was unrelated to the surgery or was the decision-making encounter; tie the note directly to the modifier used; show the diagnosis distinguishing the visit from post-op care. The key is matching the documentation to the payer's own rule for global surgery period (e/m during global) denials.

Is a Global Surgery Period (E/M During Global) denial worth appealing?

Global-period bundling hides real E/M work inside the surgical fee, the right modifier plus a note proving the visit was separate is what recovers it. A no-risk recovery service makes it easy to find out, you only pay on what's actually recovered, so there's no cost to working the ones that are winnable.

How does Volari handle Global Surgery Period (E/M During Global) denials?

Volari's AI agents identify global surgery period (e/m during global) denials in your written-off pile, build each appeal with the right documentation and payer-specific argument, file it, and follow it to payment. You pay 25% only on what's recovered, and nothing if nothing comes back.

Other denial types

Modifier 25 →Medical Necessity →Timely Filing →Prior Authorization →Bundling / NCCI Edits →Missing or Invalid Information →Coordination of Benefits →Non-Covered Service →Duplicate Claim →Experimental / Investigational →Downcoding →Eligibility / Coverage Not in Effect →Referral Required / Absent →Diagnosis Inconsistent with Procedure →Provider Not Eligible / Credentialing →Frequency / Units Exceeded (MUE) →Step Therapy / Fail-First →Site of Service →Telehealth POS / Modifier →Auth on File but Still Denied →Out-of-Network / Network Status →Assistant Surgeon →New vs Established Patient →Drug / J-Code Units →Screening vs Diagnostic →LCD / NCD (Medicare Coverage Policy) →Documentation Insufficient →Corrected Claim Denied as Duplicate →

Volari's AI agentic crew that works your pile

The same AI agents that build and file your global surgery period (e/m during global) appeals inside the app, each a specialist at one part of the fight, paid only on what they bring back.

Reva

Lead

Cody

Coding

Denny

Appeals

Faye

Follow-up

Iris

Intel

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