# Modifier 76 & global period



## PMiklavcic (Jul 31, 2012)

Our doctor saw a patient for an I&D (10 day global period) of a finger abscess & has been seeing the pt for f/u which falls in the global period.......8 days later the doctor had to re-I&D the abscess......is the 76 modifier appropriate for the 2nd I&D?   & does the global period start over with the 2nd I&D?  (the doctor is seeing the pt on day 12 for f/u & I'm not sure if this is global or billable)    Any help is appreciated.

Thank you!


----------



## aaron.lucas (Jul 31, 2012)

no, 76 wouldnt be correct, that's only if the procedure was repeated on the same day.  for this I would guess 78, because the doctor didnt plan on doing another I&D right?  if it was planned or staged then 58 would be appropriate, otherwise use 78 for an unplanned return to OR for a related procedure.  for modifier 58 the global the global resets, but for 78 it does not.  this is because 78 is usually used when you have to go back and fix something.  as far as day 12 follow up, if it's unplanned like I think it is then you should be ok, because the global will not have started over again.  does this all make sense?


----------



## PMiklavcic (Jul 31, 2012)

This is being done in an office setting (PCP office)......I was going back & forth b/t the 76 & 78 & was thinking the 78 was more appropriate but the "return to the OR" was throwing me off being that it was being done in the office.

The re-I&D was not planned at all......so if I am understanding correctly, the global period does not start over w/the 2nd I&D so the f/u on day 12 of the original I&D is billable to the insurance co, correct??

I appreciate your time & response.


----------



## aaron.lucas (Jul 31, 2012)

Yeah, you would still use 78, because the guidelines state that it doesnt necessarily have to be an OR, or the same OR.  It's more to represent the fact that you had to perform another related procedure during the global period, and that it was not planned (usually due to a complication, but sometimes not).  And yes because global does not reset with 78 you should have the green light to bill the f/u on day 12, and unless there is anything else involved you wont need a modifier.


----------



## PMiklavcic (Jul 31, 2012)

Thank you so much!


----------

