Question: Aside from some new verbiage in Appendix A of CPT concerning modifier 59 (Distinct procedural service), are there other modifier changes that outpatient and ambulatory facilities should be aware of for 2008?
California Subscriber
Answer: There are some minor additional changes to modifiers for CPT 2008.
A slight revision to the text explaining modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) in Appendix A confirms that you may append the modifier to staged or related procedures that were "anticipated" at the time of the original surgery, not just ones that your surgeon planned in advance.
Many coders were already using modifier 58 when the doctor only anticipated the possibility of surgery instead of planning it. This change will just make those coders more comfortable with that usage.
Also, the descriptor for modifier 78 gains new verbiage and now reads, "Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period." Previously, modifier 78 did not specify an "unplanned" return.
Once again, the revisions serve to add detail and reinforce what has always been proper use of the modifier, rather than create any new conditions for use.
