Pulmonology Coding Alert

Question: What›s the difference between an “XXX” global period and a “000” global period?

New Jersey Subscriber

Answer: There is a distinct difference between these two global periods. The classification XXX (Global surgical rules do not apply) means the service is truly free of global surgical bundling issues. You can separately report services, such as E/M visits, that you perform on the same date as a surgical procedure with an XXX global period.

The 000 classification means the procedure adheres to bundling rules only on the date of the service. Medicare will therefore bundle certain services that you perform on the surgery date into codes with this 000 global period.

Best practice: You should still append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to the E/M code if you report it on the same day as a procedure with an XXX global period. Modifier 25, along with physician documentation, proves the E/M service was “significant” and therefore more in-depth than the typical E/M component the procedure code already includes. Some payers will require modifier 25 with XXX services (such as 94010, Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation).