General Surgery Coding Alert

Find out if youre a modifier coding pro by checking your answers to the five quiz questions on page 60 against this answer key. Answer 1: A. For Medicare payers, you should append modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) to the open procedure to indicate that the diagnostic endoscopy and the open surgical service are staged or planned. Pitfall: While modifier 59 (Distinct procedural service) may seem appropriate, the Correct Coding Initiative (CCI) specifically states that if there is another appropriate modifier -- in this case, 58 -- you should use that modifier instead of 59. Some payers may still want you to use 59, along with 58, so check with your individual payer. Answer 2: B. If the surgeon converts to an open surgery during a laparoscopic procedure, you should only report the open procedure, according to CPT and CMS guidelines. [...]