How much is Allowed During the Global Period Using Modifier 58, 78 and 79

How much is Allowed During the Global Period Using Modifiers 58, 78 and 79

These 3 Modifiers are commonly used when the service was rendered during the Surgical Global Period. And you might be wondering how are they being reimbursed based on the allowable amount? Well, here’s what I thought I should be sharing to you.

Modifier 58

 What it indicates, “staged or related procedure or service by the same physician during the post-operative period.” when;
  1. planned at the time of the original procedure, or staged;
  2. it is more extensive than the original procedure; or
  3. a therapy following a diagnostic surgical procedure.

*** DO NOT use Modifier 58 if the Procedure is Converted from Laparoscopic to Open Procedure

Reimbursement: 100% of the allowable amount

Modifier 78

 What it indicates,  “unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the post-operative period. When this procedure is related to the first and requires the use of an operating or procedure room, it may be reported by adding modifier 78 to the related procedure.”

Reimbursement: Likely up to 80% of the allowable amount; why? well, its because it is related to the procedure that is within the global period.

Modifier 79

 What it indicates, “unrelated procedure or service by the same physician during the post-operative period.”

Reimbursement: 100% of the allowable amount

Need Immediate Help? 

CHAT WITH US/TEXT/CALL 

(888) 822-0862

Email: pinky.maniri@gmail.com

 We Offer CONSULTING SERVICES 

We always OVER-DELIVER!

100% Satisfaction Guaranteed. Or we will return your money!

We offer hourly coding consulting time on certain specialty only:

  • Pain Management
  • General Surgery
  • Anesthesiology
  • Physical Medicine and Rehabilitation
  • Dermatology
  • Obesity Medicine
  • Sports Medicine
  • Neurology
  • Spine and Orthopedic Surgery
  • Physical Therapy / Occupational Therapy / Speech Pathology
  • Chiropractic Services
  • Workers Comp and Motor Vehicle Accident Cases

Medical Billing, Coding, Reimbursement and E/M Questions?

We can help you navigate your practice on how to INCREASE REVENUE by looking at additional Services that you can possibly do in your Practice based on your Specialty.

Other Services We Offer:

  • Setting up a Medical Practice
  • Revenue Cycle/Reimbursement Management
  • Insurance Credentialing and Contract NegotiationsMedicare Enrollment and Credentialing
  • Chart Auditing
  • Staff Training
  • Compliance Program

Dig Deep, Dig Deeper, Still Deeper ... until you find what you are looking for.

Author: Pinky Maniri

Ms. Pinky, as she is fondly called - is a Reputable Professional Consultant and Expert in Practice Administration, Medical Billing, Coding, Health Information Technology, Insurance Credentialing and Compliance for Physician Offices. Well-educated with a Degree in Computer Systems Engineering and a background in Clinical Nursing and Small Business Management. Her professional mission is to make sure her clients/physicians maximize reimbursement while they remain compliant with the current rules, changes, guidelines and policies. Read More About Ms. Pinky here and See what Other's say about her Expertise Testimonials

Share This Post On