Results 1 to 8 of 8

Modifier 58 or 76 or 78

  1. Arrow Modifier 58 or 76 or 78
    Medical Coding Books

    In the ASC arena, a patient came in for a nerve root injection. The MD discussed with the patient the possibility of taking the patient back to the OR to perform an injection at a different level if the first one was not successful. The injection was performed and the patent taken to the recovery room. After a discussion the the patient in the recovery room, the MD took the patient back to the OR to perform another injection at a different level. Which modifier is appropriate and why?


  2. #2
    St George, UT
    What were the levels injected and what injection was documented? Was it a selective nerve root block/transforaminal injection? If so, I would use 64483 for the first level and 64484 for the 2nd injection.

  3. Default
    If I remember correctly, the first trip to the OR was documented as T10 intercostal nerve (64420) and the second trip was T11 intercostal nerve (64420).

  4. #4
    If the CPT code 64420 is correct , which I'm questioning because you state "nerve root" injection and 64420 is a relatively non invasive block, then I would use the -76 modifier (repeat procedure). The -58 and -78 modifiers are not appropriate as CPT 64420 has no global period. I would also not consider 64421 (multiple levels) because they were performed at separate settings.

    Julie, CPC

  5. #5
    since this is a return to the OR on the same date of service, you are an ACS, he injected a totally different level, then I would use the 59 modifier.

    I would not use the 58 because it was not staged or planned at the time of the original injection to return the patient to OR (in other words not scheduled).

    Since its a different level, 78 would not be appropriate either.

    Mary, CPC, COSC

  6. #6
    Duluth, Minnesota
    I agree with mbort - I'd be using a .59 modifier on the second code.
    (nicely explained!)
    Donna, CPC, CPC-H

  7. #7
    I agree the -59 modifier is also appropriate, however, I've had carriers still deny the second block, same CPT code (different level) with the -59 modifier stating that since the CPT does not specify exact level that the -76 modifier is necessary to pass the edits.

    Julie, CPC

  8. Default
    Thanks for your help.

Similar Threads

  1. Replies: 2
    Last Post: 09-18-2015, 01:17 PM
  2. Modifier 59 vs Modifier 91 for Laboratory
    By leahrey in forum Modifiers
    Replies: 1
    Last Post: 06-23-2015, 12:01 PM
  3. MODIFIER PT VS MODIFIER 33 Screening Colonoscopy
    By Ann Johnson in forum Modifiers
    Replies: 2
    Last Post: 07-19-2012, 07:08 AM
  4. Modifier 58 versus Modifier 78
    By Ramona03 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-04-2012, 12:10 PM
  5. Modifier 51 Versus Modifier 59
    By Sborkowski in forum Modifiers
    Replies: 3
    Last Post: 05-26-2009, 03:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.