AAPC - Back to school
Results 1 to 4 of 4

Thread: FX care - 2nd request please

  1. #1

    Default FX care - 2nd request please

    AAPC: Back to School
    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!

  2. #2
    Join Date
    Apr 2007
    San Antonio, Tx


    You would still use modifier 78 because if you look at the explaination for the modifier, it says "Unplanned return to the operating/procedure room. Place of service is not the cause for usage of the modifier, but the timing (when it occurred) of the procedure itself. Just my interpretation of this modifier.
    Ray Galvez CPC

  3. #3


    My opinion is if the doctor knew he/she was taking this pt to the OR (they discussed the surgery before) for this surgery then I would use 58 modifier. The way I interpret 78 mod is when the pt has to go to the OR right away for example a post op complication, that was not discussed prior.
    Hope that helps.

  4. #4
    Join Date
    Apr 2007
    Greeley, Colorado


    I would use -58. Look at the description in Appendix A of your CPT. It states -58 is used to report a more extensive procedure than the original, etc. I think of -78 as more of an uh-oh kind of modifier, where -58 would indicate that the second procedure could have been expected. Hope that helps.
    Lisa Bledsoe, CPC, CPMA

Similar Threads

  1. 2nd REQUEST
    By Lisa A in forum Orthopaedics
    Replies: 6
    Last Post: 01-31-2011, 07:12 AM
  2. 2nd request Fracture Care Help
    By Snflwr in forum Orthopaedics
    Replies: 3
    Last Post: 12-09-2010, 02:58 PM
  3. 2nd request, please help if you can :0)
    By JenReyn99 in forum Orthopaedics
    Replies: 8
    Last Post: 11-08-2010, 09:38 PM
  4. 2nd Request NP vs PA
    By Lisa A in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 11-04-2010, 01:20 PM
  5. 2nd request
    By kdahlen in forum Orthopaedics
    Replies: 0
    Last Post: 03-30-2009, 10:17 AM

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.