AAPC - Back to school
Results 1 to 3 of 3

Thread: Modifier 58 - I need some clarity

  1. #1
    Join Date
    Apr 2007
    Long Beach

    Default Modifier 58 - I need some clarity

    AAPC: Back to School
    Help... I need some clarity on this. My surgeon did a lapband procedure. During the global period he wants us to bill for the first adjustment, using the modifier 58. The procedure code is S2083. My question is really two parted. First, can you even us a modifier on a HCPCs code? Two, is the adjustment included in the global fee. I understand the surgeons rationale, this is a planned procedure. I just feel funny about billing this way.
    I would really appreciate it if someone could shed some light.

    Thank you

  2. #2
    Join Date
    Apr 2007


    I have almost the same question. I always thought if the fill was performed during the 90 day global period that it was included and not seperately billable. I was doing some research and found this...

    **The majority of bariatric surgical procedures have a 90-day post-op period**
    Any E&M services unrelated to the initial procedure may be billed within the post-op period, if appended with modifier 24. (i.e. band adjustments, abscess)

    Band adjustments are very common during the post-operative period, sometimes even within the first month following surgery. These visits should be billed with a 24 modifier.

    Coding Example:

    99214-2425 Office visit during PONC period
    10022 FNA w/guidance (for adjustment)
    76942 Radiological guidance
    A4209 Needle syringe
    J7050 Saline solution
    (common reason: dysphagia/difficulty swallowing)

    From: http://www.supmedmgmt.com/medical-ga...ass-coding.php

    I don't know how I feel about billing adjustments during the global period. We use S2083 for the adjustment of the bands.

    Any advice???
    Christina Lee Wagner, CPC, CPC-H

  3. #3
    Join Date
    Apr 2007
    Long Beach

    Default Found my anwser

    Well if it were a snake, it would have bit me by now. It states right in the CPT book that Adjustments in the global period are considered typical follow-up care in the global period. So there is not Billing for adjustments.

    This is what CPT states...

    Adjustments during the global are bundled and not reported separate. Per CPT Guidelines:

    Typical postoperative follow-up care (see Surgery Guidelines, CPT Surgical Package Definition) after gastric restriction using the adjustable gastric restrictive device includes subsequent restrictive device adjustment(s) through the postoperative period for the typical patient. Adjustment consists of changing the gastric restrictive device component diameter by injection or aspiration of fluid through the subcutaneous port component.

    Hope this helps everyone. I should have just READ!!!

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.