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Mod 58 or 76?

  1. Question Mod 58 or 76?
    Medical Coding Books
    I need help deciding which modifier is the correct one to use in this situation.
    Pt. presents with cyst that was I&D and then pt. returned two days later for repacking. The same MD happen to check the wound on that 2nd visit and decided to re: I & D because "pus still present". Do I charge another E/M and procedure and what modifier do I use?? Thanks for any help

  2. #2
    Milwaukee WI
    Default NO E/M and -76 or -78
    No E/M code.

    I'd use the -76 modifier (repeat procedure in global period) as long as the procedure code is exactly the same as the first procedure.

    If it's a different procedure code I'd use -78.

    I would NOT use -58 because you didn't plan to return to the OR (or procedure room) for a repeat or related procedure.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Albany, New York
    That would have been my response as well........
    Karen Maloney, CPC
    Data Quality Specialist

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