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  • Does Surgery During the Global Period Start a New Post-Operative Period?

    I learned when a patient has a YAG laser capsulotomy within the global period of cataract surgery in the same eye, the post-operative days do not start again. I wonder if this only applies to cataracts and YAG capsulotomy, or does it apply to any surgery?

    When surgery is performed by the same surgeon within another procedure's global period, a modifier is required for payment. The definitions of the surgical modifiers (-58, -78, -79) determine if a new post operative period begins or not. For example, when reporting CPT code 66821, YAG laser capsulotomy during the global period of cataract surgery in the same eye, append modifier -78, as it is related and an unplanned return to the operating or procedure room. The laser will be paid at 70% paying the intraoperative portion of the procedure only, however the original cataract surgery global period remains. Download the surgical modifier decision tree at

    Review the modifier chapter in Fundamentals of Ophthalmic Coding to master modifier usage. Missing or incorrect use of a modifier(s) is one of the top five reasons payers reject insurance claims.