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Primary Care Coding Alert

You Be the Coder:

Two Lesions,One Global Period

Published on Sat Jun 01, 2002

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: The family physician removed a malignant lesion, and the patient returned within the 10-day global period to have a benign lesion removed at a different site. How should I code for a similar procedure within the global period of the initial one?

Montana Subscriber

Answer: Use the appropriate lesion excision code (e.g., 54060, Destruction of lesion(s), penis [e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle], simple; surgical excision) for the second removal appended with modifier -79 (Unrelated procedure or service by the same physician during the postoperative period). Modifier -79 indicates to the payer that the second procedure is separate and unrelated to the first and therefore should be reimbursed. If a different physician removes the second lesion, modifier -79 is not necessary. Many coders confuse modifier -78 (Return to the operating room for a related procedure during the postoperative period) with -79. Both separate the second procedure from the global period of the first, but modifier -78 indicates that the procedure is related.

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