Anesthesia Coding Alert

Question: Is it appropriate to use modifier 58 on anesthesia encounters when the surgeon plans to return to the OR for a staged procedure?

New Hampshire Subscriber

Answer: Global surgery modifiers such as 58 (Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period) are not appropriate for anesthesia. Based on the CPT® definition, modifier 58 would only be appropriate for use by the surgeon performing the procedure if they are within the global period of a surgery that they performed. Modifier 58 is not for use on anesthesia codes and should not be reported by the anesthesiologist since that is a different provider of a different specialty.

Plus: The global surgery rules indicate that “services of other physicians related to the surgery” are excluded from the global surgery package. By extension of that rule, there would be no reason to append a modifier to an anesthesia service.

You can find more information is in the CMS global surgery booklet at www.cms.gov.