A patient came into the orthopaedic office with a lumbar compression fracture. The office visit is coded with closed treatment, 22305, POS is OFF.
One month later the patient had to have lumbar surgery, fusion, decompression, etc. POS is Inpatient. My question is: Does this surgery need a modifier? It is within the global of the office visit of fracture care, but I'm not sure it matters.
Modifier 78 wouldn't work in my opinion because it is meant for "return" to operating room. The original treatment was in the office and not an operating room so I do not feel 78 would be used. Additionally, this surgery was not a complication of the closed treatment (22305).
Mod. 58 is the only thing I'm considering. I'm split in half though, because I do not feel the actual surgery was a "staged" procedure. However, you could make the arguement that it is a "related" procedure. Opinions? Thanks!