Coding ‘covering’ physicians during the global period
Q
Please explain what “by the same physician” means in the CPT definition of modifiers -24, -58, -76, and -79. Does it mean literally the same physician or can it mean within the same group practice and specialty, i.e., same tax ID number?
A
Simply put, it means “the physician who performed the last procedure that initiated the global period.” What makes the situation more complex is how insurance companies process claims for physicians within a group practice and how they treat covering physicians during the global period. The question then becomes: How will my insurance company view the use of these modifiers for payment purposes? For instance, the modifier -24 means that the physician who performed the original surgical procedure is now seeing the patient for an unrelated problem (E/M service) during the global period. If all physicians in a single-specialty practice are considered the “same physician” for billing purposes, use this modifier to bypass the global period restrictions for postoperative care.
