Wiki Modifier 58 vs. 79

Create Wiki
A

ariel0915

Contributor
Messages
15
Best answers
0
A patient was seen on DOS 10/11/10 for a lithotripsy for rt renal calculus and then returned on DOS 10/15/10 for a additional lithotripsy for residual fragments and bladder calculi.

For DOS 10/11/10 it was billed as
50081
50395
50392
50393
50394
74425

For DOS 10/15/10 it was billed and denied for included in primary procedure
50080
52310

For DOS 10/15/10 can you bill a modifier 58 because it is related to the primary procedure. We are having a debate in the office over the use of 58 vs. 79. Can someone please help shead light on this.:confused:
 
If the documentation indicates the patient was informed that additional surgery for remaining stone fragments may occur you would certainly be able to use mod 58.

If there is no discussion (documentation) about a possible return trip to the OR in that case I would use mod 78 because the condition is related.
 
You must log in or register to reply here.
Top