Minor vs. Major Procedure

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May 12, 2016

Question:
What is the difference between a minor and major procedure?

Answer:
A minor procedure is defined as one with a zero or 10 day global period.  For example, debridement has a zero day global period, and excision of a benign skin lesion has a 10 day global period.  A major procedure is defined as one with a 90 day global period.  Most open surgical procedures have a 90 day global period. Procedures are paid a global “flat fee” and E/M visits and other procedures directly related to the original procedure during the global period are considered inclusive to that procedure and not separately reported/billed.  Exceptions occur and modifiers are used to describe these exceptions and allow payment. For example, you perform an unrelated procedure during the global period or one that is staged from the first.  Refer to the modifier section of the CPT manual for descriptions of modifiers and attend a KZA Coding workshop to learn how to accurately use modifiers specific to your specialty.

*This response is based on the best information available as of 05/12/16.