Reader Questions:
Get This Prior-to-Surgery Modifier Advice
Published on Sat May 09, 2009
Question: The ob-gyn planned a radical hysterectomy (58210). The patient's preoperative labs turned up diabetes. Her blood sugar was so severely elevated that my doc admitted the patient to the hospital to get her sugar under control before he would do the surgery. The patient was admitted on 1/11 for the diabetes, and the surgery took place on 1/14. Can we charge the hospital admit and subsequent visits that occurred prior to the surgery date? If so, should I use modifier 59 or 79? And can I still use 57 on the date of the surgery even though it was planned several weeks earlier? Maine Subscriber Answer: No modifiers apply to the E/M codes you will bill because the diagnosis is uncontrolled diabetes, not the reason for the surgery.-In this case, just bill the hospital admission (99221-99223, Initial hospital care, per day, for the evaluation and management of a patient [...]