Global Periods in the ASC
Every procedure performed in the ambulatory surgical center (ASC) has a “same day” global period. This makes sense, as the ASC is not reporting physician work services, but only facility fees.
For instance, if a patient experiences postoperative bleeding and the physician must return the patient to the ASC for control of bleeding on the same day, you would report the appropriate code for the procedure performed to control the bleeding with modifier 78 Return to the operating room for a related procedure during the postoperative period appended because the procedure occurred within the “same day” global period for the ASC.
If, however, the physician returned the patient to the ASC the day after the initial surgery, you would report the appropriate control of bleeding code with no modifier attached. For the ASC, the global period of the initial surgery has expired, even though the surgery includes a 90-day global period for physician services.