Modifiers

ShelleyM

Networker
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50
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Would someone please explain the difference between modifier 58 and 78 in very detailed terms? I have such a problem with these. Can you also suggest some reading or online tools that might help? Thank you very much!
 
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165
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San Diego
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Hi,

Modifier 58 - It was explained to me that this modifier was for "staged" procedures. Those procedures for which you know will not be completed in one surgical session and for which the patient will have to return to OR for completion of the total procedure. An example I was given was "hemorrhoidectomies"; I was told that these are removed in stages so as to reduce patient discomfort and to produce the best results. In the case of this type of procedure, the "stages" of it are often times pre-scheduled. Going into the first "stage", you know there will be more to come.

Modifier 78 - Just the opposite....this is an "unplanned" return to the OR. The patient must return to the OR for problems that were unforseen and that have arisen. These returns to the OR are unplanned and therefore "unstaged" - i.e. complications.

Hope this helps!
 

ShelleyM

Networker
Messages
50
Best answers
0
Hi,

Modifier 58 - It was explained to me that this modifier was for "staged" procedures. Those procedures for which you know will not be completed in one surgical session and for which the patient will have to return to OR for completion of the total procedure. An example I was given was "hemorrhoidectomies"; I was told that these are removed in stages so as to reduce patient discomfort and to produce the best results. In the case of this type of procedure, the "stages" of it are often times pre-scheduled. Going into the first "stage", you know there will be more to come.

Modifier 78 - Just the opposite....this is an "unplanned" return to the OR. The patient must return to the OR for problems that were unforseen and that have arisen. These returns to the OR are unplanned and therefore "unstaged" - i.e. complications.

Hope this helps!
Thank you very much! This does help!
 
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