Modifier 58=The global period restarts with the subsequent procedure, and the surgeon should receive 100 percent of the allowable reimbursement on both the first and the subsequent procedures.
Modifier 78=Conventionally, modifier 78 results in a decrease in reimbursement assigned to the “intraoperative” portion of the case. For example, Medicare reduces reimbursement by 69 percent, but other payors may use a different percentage.
The other issue to remember is that appending modifier 78 to a procedure ties the global period to the original case.
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