How does modifier 58 affect reimbursement?

Modifier 58: to indicate a second procedure was performed as a staged procedure. Reimbursement should be 100% of the allowable fee. Modifier 79: To indicate an unrelated procedure was performed during the global period of the original procedure. Reimbursement should be 100% of the allowable fee.

Can modifier 58 and 79 be used together?

Modifiers 58, 78, and 79 are all used in conjunction with procedures performed within the global period of another procedure.

Can you bill for post op complications?

Coding for postoperative complications The CPT Manual states in the surgery guidelines section that any complications, exacerbations, recurrence, or presence of other diseases requiring additional services are not included in the global period, so coders may report them separately.

When can I use modifier 58?

When to Use Modifier 58. Modifier 58 is used for a “staged or related procedure or service by the same physician during the post-operative period.” Further, according to CMS.gov, modifier 58 indicates that the procedure was: Planned, either at the time of the first procedure or prospectively.

Does modifier 58 restart the global period?

Modifier –58 reimburses the surgeon based on 100 percent of the allowed amount and restarts the global period (as long as it exceeds the first global period).

What is the meaning of modifier 58 in surgery?

Modifier 58 is defined as a staged or related procedure performed during the postoperative period of the first procedure by the same physician. A new postoperative period begins when the staged procedure is billed. Report when a procedure or service during the postoperative period was: For therapy following a diagnostic surgical procedure

When to use the global period modifier 58?

A new global period begins with each subsequent procedure, and usually there is no reduction in reimbursement. Modifier 58 may be used during the global surgical period for the original procedure only. It may not be used for staged procedures when the code description indicates “one or more visits” or “one or more sessions.”

When do you use a.no.modifier 57?

A. No. Modifier –57 is appended to the appropriate level of exam when the decision to perform a major surgery (one with a 90-day global period) is made. Modifier –25 indicates that the exam is “separately identifiable.”

When to use the 79 unrelated modifier in surgery?

Modifier –79 Unrelated procedure or service by the same physician during the postoperative period. The procedure could be unrelated because it is performed in the other eye. Or it could be a new problem, not related to the initial surgery of the same eye. Payment is 100 percent of the allowable, and a new global period begins.