Parathyroidectomy

laurijean

Networker
Messages
46
Best answers
0
My Doctor performed a Parathyroidectomy 60500 6 weeks ago and had to go back for a re-exploration (60502) what modifier should I bill with the 60502 to by pass global edits,
a 58 or 79?
 

ljones88

Networker
Messages
84
Location
Stuart, Florida
Best answers
0
I had this exact situation before. Modifier 58 is correct. We billed with 58 and the claim was paid, after notes from 1st surgery and follow up surgery were sent it with a cover letter.

From Barbara Cobuzzi, I found asking these questions re: modifier 58 helped immensely.
Ask yourself:

1) Is the original condition is being treated?
2) Is the subsequent procedure more extensive than the first because the desired outcome was not accomplished?
3) Is something being done to “finish” what was started with the prior procedure?
4) Is a procedure being done to facilitate therapy, or is it therapy following a prior procedure?

Answering yes to any of these questions will direct you to the 58 modifier.


Modifier 79 is for an unrelated procedure during a post op period. It is used in the strictest sense for care that is entirely unrelated to the prior surgery that created the current global period. More than likely, the claim for 60502 will be sent with the same or similar diagnosis as the claim for the first surgery. Edits will stop that claim and deny it for records or deny for "inappropriate use of a modifier".
 
Top