Otolaryngology Coding Alert

Question: The physician performed postoperative debridement in the office following septoplasty. Should we report modifier 58 or modifier 79 since the septo was the procedure with the global period? 

Washington Subscriber 

Answer: The correct modifier you would report depends on the circumstances in which the procedure was performed.  

You would include modifier 58 (Staged or related procedure or service by the same provider or other qualified health care professional during the postoperative period) if this was a staged procedure or related procedure to the procedure with the global procedure. This applies if the debridement is related to the septoplasty. 

You would report modifier 79 (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period), however, if the follow-up procedure (in this case, the debridement) is unrelated to the procedure with the global period (the septo), but related to the sinuses for which the zero day global endoscopic sinus surgery was performed. 

So, in the case of post-operative FESS sinus debridements when the surgeon performs a septoplasty and/or turbinectomy during the same operative session (30130, Excision inferior turbinate, partial or complete, any method and 30140, Submucous resection inferior turbinate, partial or complete, any method) these codes also have a 90-day global period. Because of this, you should append modifier 79 to 31237 (Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement [separate procedure]).