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;
- planned at the time of the original procedure, or staged;
- it is more extensive than the original procedure; or
- 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
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