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Gastroenterology Coding Alert

Modifier:

Get The Approval Your Deserve -- If You Know The Ins And Outs To Coding Modifier 58

Published on Mon Aug 01, 2011

Clue: Complication procedures go with a different modifier.When a patient takes another trip to the operating room during the global period, you owe your provider that extra code for the added service. But not all follow-up trips warrant a modifier 58. Bust your confusion by following this two-step guide.Step 1: Keep Modifier Definition, Mandate IntactAccording to CMS guidelines, you would use modifier 58 (Staged or related procedure or service by the same provider during the postoperative period) when a second surgery is performed in the postoperative period of another surgery when the subsequent procedure was: planned or "staged;" more extensive than the original procedure; for therapy following a surgical procedure; or for the reapplication of the cast within the 90-day global period.In 2008, the American Medical Association (AMA) changed the description for modifier 58 to include the phrase 'planned or anticipated.' "This allows for a broader application in situations where [...]
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