Wiki septal mass

[lstapel@clinicservice.com]

On Jan19/18 performed bx and destruction of ulcerated mass on septum. Code 30117 was used. This was done in the office trying to avoid a trip to the ER for this 91 yr old female. Based on the pathology report it was necessary to go to the OR. On 2/12/18 a complex excision of left septal mass with reconstruction and placement of silicone sheeting, bilateral inferior turbinate outfracture for access was performed. Medicare complete denied 2/12/18 as part of global period. Would 58 be the best modifier to use on the 2/12 surgery? 78 would be appropriate except the 1st procedure was done in the office. Any recommendations?

 

[b.cobuzzi]

58 is the exact modifier you should use. First, conservative treatment was attempted but that was not enough and you needed to treat the sabre condition, only with a more extensive surgery. That is modifier 58 by it's very description.

Even if the surgery took place in an OR,78 would be wrong because you are not treating a complication caused by the first surgery. You are finishing what the first surgery could not. And that calls for a modifier 58.

Barbara J. Cobuzzi MBA, CPC, COC, CPC-P CPC-I CPCO, CENTC
Consulting Editor Otolaryngology Coding Alert
www.CRNHealthcare.com
b.cobuzzi@att.net