Primary Care Coding Alert

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.