Wiki 58 appropriate?

[solocoder]

With one of the uses for a 58 modifier being "for therapy following a surgical procedure", I am wondering whether subsequent debridements of an ulcer (after i&d or surgical debridement) could be considered "therapy following a surgical procedure"? The doctors usually don't state in their op notes that staged debridements will be necessary, so I couldn't say it falls under that part of the definition of 58.
Or are only certain things considered "therapy following a surgical procedure"?
Any thoughts?
I may be over-straining my brain again here.

 

[Porter_kd]

I have thought about this situation many times myself. I have tried using the modifier 58 for the debridement codes during the global period. It seems the claim gets rejected with this modifier. Upon reading the guidelines, it states the procedure needs to be planned at the time of the original procedure. For most follow-up debridements after a surgical procedure, most doctors don't anticipate this being done for the healthy patient. I have been taught to use the modifier 78, since it is unplanned and it is related to the original procedure. Most healthy individuals having a surgical procedure don't need wound care many times after having the surgery to correct the problem. Unless the doctor documents at the time of the surgery for the need of f/u debridements, then you could use the modifier 58.

 

[solocoder]

Thank you for your reply!