Foot and ankle surgeries—from bunion corrections to fracture repairs—require precise billing to avoid lost revenue. One of the biggest challenges is understanding how global surgical periods impact reimbursement.
Understanding Global Periods
Each surgery CPT code has a global period—0, 10, or 90 days—during which related post-op visits are bundled with the procedure payment.
For example:
- Bunionectomy (CPT 28292): 90-day global
- Simple nail removal (CPT 11730): 10-day global
Billing for post-op care during this time may result in denials if not coded correctly.
Modifier Usage
- Modifier 24: Unrelated E/M service during post-op period
- Modifier 58: Staged or planned procedure during post-op
- Modifier 78: Unplanned return to OR for related procedure
- Modifier 79: Unrelated procedure by same provider during post-op period
Documentation Tips
- Clearly document when a visit is unrelated to the surgery (e.g., contralateral foot issue).
- Indicate staged procedures in the operative note if planning multiple interventions.
- Track global period start and end dates in your EMR to avoid unintentional denials.
Avoiding Revenue Loss
- Capture separately billable services like casting, X-rays, or injections that are not part of the global package.
- Educate staff on which codes are bundled vs. separately payable.
