Wiki Modifier 52

[tbensonite]

I could use some help with this one please.
I want to bill a Revision of Total Knee Arthroplasty but the doctor only exchanged the poly liner. It was during the global period. My question is can I bill this as 27486-52-78? Seems kind of odd to me but I'm hoping somebody can explain as the mod 52 will reduce reimbursement but so will 78. Maybe I'm just not quite awake yet

Thanks a bunch!

 

[PLAIDMAN]

I could use some help with this one please.
I want to bill a Revision of Total Knee Arthroplasty but the doctor only exchanged the poly liner. It was during the global period. My question is can I bill this as 27486-52-78? Seems kind of odd to me but I'm hoping somebody can explain as the mod 52 will reduce reimbursement but so will 78. Maybe I'm just not quite awake yet

Thanks a bunch!

I agree w/ 27486-52-78 yes the 52 will reduce your pay but it is appropriate - he did not revise a "full" component. the 78 will reduce pay- but it does not change your global, so you are not stuck with another 90 days of no charge.

I use the 52 a lot on xrays - my docs don't like name # of films/views.

 

[tbensonite]

Thank you so much. I really wrestled with this because I could only imagine my doc getting paid a couple dollars for what he did but we do have to comply with correct coding principals. I appreciate your response