Global Period Billing: The Compliance Trap Catching Orthopedic Practices

Global surgical periods are one of the most frequent sources of both lost revenue and compliance risk in orthopedics. The rules are deceptively simple — services related to the surgery are bundled; unrelated services are separately billable — but applying them correctly at scale is hard.

The most common error we see is reflexive modifier 24 usage on every post-op E/M visit. When an auditor pulls the chart and finds the visit was routine post-surgical care, each one becomes a repayment plus potential penalty. The inverse error is just as costly: practices that stop billing entirely during global periods forfeit legitimate revenue for genuinely unrelated problems.

The documentation standard is clear: the note must independently establish that the visit addressed a condition unrelated to the procedure, with its own history, exam, and medical decision making.

Automated chart review changes the economics here. Instead of sampling a few charts per quarter, every post-op encounter can be checked against the operative report to determine whether the visit is truly separately billable — before the claim goes out.