Wiki 58 or 78

[aguelfi]

I have a request for a refund on my desk for a patient who had a axillary node bx (38525 & 38792) abou 14 days after an excision an excision of breast lesion (19125). I used a 78 modifier because the op-note doesn't specify that the bx was a planned return to the OR, however I do see how it could be necessary to use a 58. We can't determine if the patient was going to return to OR until the results from the lesion removal are back. I'm interested to see what others think if they would use a 58, 78 or even something else. Should I appeal this?

 

[mbort]

I responded to this same post under the Modifier forum

 

[cmartin]

I think you could make an argument for either -58 or -79, but I definitely wouldn't use a -78 in that case. I'm surprised that they'd ask for a refund on the basis of what they consider to be inappropriate use of a -78, tho.
C.Martin
CPC-GENSG