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Modifiers

  1. #1
    Default Modifiers
    Medical Coding Books
    Would someone please explain the difference between modifier 58 and 78 in very detailed terms? I have such a problem with these. Can you also suggest some reading or online tools that might help? Thank you very much!

  2. #2
    Default
    Hi,

    Modifier 58 - It was explained to me that this modifier was for "staged" procedures. Those procedures for which you know will not be completed in one surgical session and for which the patient will have to return to OR for completion of the total procedure. An example I was given was "hemorrhoidectomies"; I was told that these are removed in stages so as to reduce patient discomfort and to produce the best results. In the case of this type of procedure, the "stages" of it are often times pre-scheduled. Going into the first "stage", you know there will be more to come.

    Modifier 78 - Just the opposite....this is an "unplanned" return to the OR. The patient must return to the OR for problems that were unforseen and that have arisen. These returns to the OR are unplanned and therefore "unstaged" - i.e. complications.

    Hope this helps!
    Sylvia Thompson, CPC
    Billing Supervisor
    San Diego, CA

  3. #3
    Default
    Quote Originally Posted by thompsonsyl View Post
    Hi,

    Modifier 58 - It was explained to me that this modifier was for "staged" procedures. Those procedures for which you know will not be completed in one surgical session and for which the patient will have to return to OR for completion of the total procedure. An example I was given was "hemorrhoidectomies"; I was told that these are removed in stages so as to reduce patient discomfort and to produce the best results. In the case of this type of procedure, the "stages" of it are often times pre-scheduled. Going into the first "stage", you know there will be more to come.

    Modifier 78 - Just the opposite....this is an "unplanned" return to the OR. The patient must return to the OR for problems that were unforseen and that have arisen. These returns to the OR are unplanned and therefore "unstaged" - i.e. complications.

    Hope this helps!
    Thank you very much! This does help!

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