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
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.
2015 Medicare Modifier 59 Changes with 4 New Modifiers
2015 Useful New Modifiers for Physical Therapy Billing and Coding
When to Use Modifier 33 Preventive Service
Can I use modifier 59 for CPT 99204, 99213, 99214, 99215, 99205, 99203 Problem Focused E/M
DME Durable Medical Equipment Billing Coding Modifier RR, KH, KJ, KI - Rental DME Modifier
