# RFA on back to back days



## missyah20 (Nov 18, 2014)

Hey - 

My provider did a lumbar RFA on the left side on one day.  The patient returned the very next day and had lumbar RFA on the right side.  

I already have the LT/RT modifiers on the claim and resubmitted with a 76 for the second day, but Medicare has denied as unprocessable (MA130).  

Any ideas on what I can use to help get Medicare to process this?


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## mhstrauss (Nov 18, 2014)

missyah20 said:


> Hey -
> 
> My provider did a lumbar RFA on the left side on one day.  The patient returned the very next day and had lumbar RFA on the right side.
> 
> ...




Modifier 76 isn't appropriate in this case; that mod is only used when the repeat service is performed on the same day.

RFA's have a global period, so a "post-op period" modifier is needed on the right side...79. Was the left side denied also?


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## dwaldman (Nov 18, 2014)

I believe the second day would be reported with modifier 58 for staged procedure if at the time of the first procedure it ws planned to do a staged procedure the next day.

Modifier 58 Fact Sheet
Definition
Indicates a staged or related procedure or service by the same physician* during the postoperative period
Appropriate Usage
To report a staged procedure planned at the time of the original procedure 

http://www.wpsmedicare.com/j5macpartb/resources/modifiers/modifier-58.shtml


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## missyah20 (Dec 4, 2014)

Hey - thanks for the responses.  I just check the operative note for the Left side RFA and the right side was a scheduled procedure at that time.  I think I am going to try the 58 here.

Thanks again.


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