Our physician has placed a tunnelled dialysis catheter during the post op period of AV graft placement (36830).

We are questioning what the appropriate modifier would be for 36558. The catheter placement is related to the underlying condition- not the graft placement. So, -79 modifier would be appropriate. However, it is understood that the patient will need dialysis while waiting for the graft to mature, so -58 would be appropriate also.

I am looking for opinions from other coders on which modifier is more appropriate. I am receiving denials for modifier -58 from WPS Medicare. Is modifier -58 not appropriate for services within a 90 day global?

Thanks in advance for your thoughts!

Michelle Hanson, CPC