WENDYBHOLLOWAY
Contributor
- Messages
- 16
- Location
- Leesburg, GA
I am located in Southwest Georgia and we are having problems getting Medicaid to pay for claims for patients who have had to return to the OR for a related or nonrelated procedure while still in a global period. Example: patient has a primary AKA for chronic osteomyelitis on 5.11.26. On 5.29.26 patient is taken back to the OR for an infected AKA & a revision of the AKA is performed. On 7.22.26, he returns to the OR for an irrigation and debridement of AKA stump down to bone for a wound dehiscence. On 7.24.26, he goes back to the OR for an I&D with delayed primary closure (returns visits to the OR are due to a noncompliant patient with multiple issues).
Per the Georgia Medicaid Provider Manual for 2026, modifiers 58, 78 and 79 are accepted modifiers. However, our claims for the return to OR deny for incorrect/invalid modifier when billed with these accepted modifiers.
We have reached out to our Provider Representative but have had no response. Are there any other coders here in Georgia who have had to submit claims to Medicaid for patients who are in a global period that can provide some feedback? It would be greatly appreciated.
Thank you,
Wendy Holloway, CPC
Leesburg, Georgia
Per the Georgia Medicaid Provider Manual for 2026, modifiers 58, 78 and 79 are accepted modifiers. However, our claims for the return to OR deny for incorrect/invalid modifier when billed with these accepted modifiers.
We have reached out to our Provider Representative but have had no response. Are there any other coders here in Georgia who have had to submit claims to Medicaid for patients who are in a global period that can provide some feedback? It would be greatly appreciated.
Thank you,
Wendy Holloway, CPC
Leesburg, Georgia