Orthopedic Coding Alert

Modifiers:

Learn the Tricks to Untangling Differences in 58, 78, and 79

Don't miss out on extra pay when global period resets.Just because you routinely append modifiers to your claims doesn't mean you're filing correctly and getting the most appropriate pay. Brush up on your modifier know-how with these tips for three of the trickiest choices: modifiers 58, 78, and 79.Remember All Possible Uses for 58The descriptor for modifier 58 seems self-explanatory: Staged or related procedure by the same physician during the postoperative period. Coders sometimes trip, however, when they forget that modifier 58 actually applies to subsequent procedures that fall into one of three categories:Planned or anticipated (staged): "A good example would be an infected hand that has to be debrided several times over the course of a couple of weeks," says Elisabeth Janeway, CCP, CPC, CCS-P, president of Carolina Healthcare Consultants in Winston-Salem, N.C. "You won't use a modifier on the first procedure, but will add modifier 58 on the [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Orthopedic Coding Alert

View All