Modifier 78 or 79

calicoder10

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Patient had an I&D of abscess of left axilla. Comes back 2 days later for check up and find to have an abscess of the right axilla. Do I use 78 or 79 modifier on 10061?

Thanks:confused::confused:
 
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I'm confused on why you're billing 10061. At the first visit for the I&D on the left side, did the provider know there was also one on the right side? Or did the provider find it on the return visit? Also, was the I&D on the right side just a run-of-the-mill type procedure or were there some extenuating circumstances that made it more than just a simple I&D?

Going off the assumption that the provider did not know about the right side when the visit for the I&D on the left happened. It was then, during the return visit, that he/she found the abscess on the right side, which I assume was also drained at that visit. I'll also assume there was nothing out of the ordinary for either I&Ds, so I'd code 10060-LT (and an E/M if appropriate) for the visit in which the left side was treated, then I'd bill 10060-RT for the visit in which the right side was treated. Obviously an office visit can't be billed for the follow up appointment for the left side I&D as that'd be global, but I'd look into the possibility of billing an E/M for the evaluation of the right side, leveling it appropriately as not to include work for the left side and applying the appropriate modifier as to prevent it from bundling with the 10060-RT.
 

mhstrauss

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Patient had an I&D of abscess of left axilla. Comes back 2 days later for check up and find to have an abscess of the right axilla. Do I use 78 or 79 modifier on 10061?

Thanks:confused::confused:

Modifier 79 is correct. Even though it's technically the same condition, given that it's a different location, it isn't related to the original abscess on the left, and therefore should not be considered part of the global period for the original procedure.
 
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