37184 code

[prallapalli]

Have question regarding appropriate modifier for this procedure. Pt had procedure 34203 on 12/01 (90 global) and then on 12/4 had procedure code 37184. Have added modifier 78/59 and insurance denied. Any suggestions.

[dpumford]

Mod 78 would be correct but you should not need mod 59 assuming that this was the only procedure done on that day.

[pygreen]

Modifier 78 is paid by the intraoperative precentage. Since 37184 has a zero global period there is no intraoperative precentage, so Modifer 78 will be denied. This is the same issue we are having. Any suggestions for getting these procedures paid would be greatly appreciated. Medicare is usually the carrier that is denying these procedures with Modifier 78. Thanks.