Global Period

A global period is the window after a procedure during which related follow-up care is bundled into the surgical payment; denials of services in that window (CARC 97) are recoverable when the care was unrelated or separately billable with the right modifier.

A global period is the span of time after a surgical or procedural service — 0, 10, or 90 days under Medicare's global surgery rules — during which routine, related follow-up care is considered already paid for in the procedure's fee. Bill an E/M visit or a service inside that window and the payer may deny it as bundled into the global package, typically CARC 97. The nuance that makes global-period denials recoverable is that not everything in the window is actually global: an unrelated problem, a return to the OR for a complication, a staged procedure, or a significant separate E/M can all be billed separately with the right modifier. The global-period modifiers each answer a specific question — 24 (unrelated E/M in the global period), 25 (significant separate E/M same day), 57 (decision for surgery), 58 (staged/related planned procedure), 78 (unplanned return to the OR), 79 (unrelated procedure). A denial sticks when the modifier is missing or unsupported; it's overturned when the documentation shows the service genuinely fell outside the global package. Working these denials means knowing the procedure's global-period length and reading the note to see whether the follow-up care was truly bundled or separately billable — a determination the payer's automated edit routinely gets wrong.

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