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Podiatry Coding & Billing Alert

Modifier 78:

Case Study: Reason Determines Correct Modifier for Metatarsal Excision

Published on Mon Mar 05, 2012

Returning a patient to the OR? Read this before assigning a code for multi-step procedures. When a patient presents with a severe infection, you can be dealing with several treatment steps -- and several potential snags for your coding. Test your coding savvy by reviewing this scenario and determining the correct modifiers when three separate surgeries are needed. Scenario: An established patient with peripheral neuropathy presents with a severe foot infection. In the course of the evaluation and management, the podiatrist completes a problem-focused exam and history to determine that immediate incision and drainage is needed (28003, Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas). He then decides to wait for the infection to subside to see if any further procedure is necessary. Four days later, the podiatrist determines that he needs to further excise bone from the second and third metatarsals (28122, Partial excision [...]
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