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

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