Over 50% Off + FREE Exam with Certification Training | Learn More
Results 1 to 7 of 7

Global Period Affected by Modifier 58 or 78?

  1. Default Global Period Affected by Modifier 58 or 78?
    Medical Coding Books
    Does using modifier 58 or 78 effect the global period calculation?
    Example: Patient has an open fracture procedure (27244) with 90 global period on 9/9/09, then has subsequent related surgeries for I&D of abscess (27301) or secondary closure (13160) that have 90 day global periods, but were billed with either 58 or 78 modifiers. Which service do I use to determine when patient is out of global period?

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    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.

    http://www.aaos.org/news/aaosnow/may09/managing1.asp


    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.

    http://www.aaos.org/news/aaosnow/sep09/managing5.asp

  3. Default
    Thanks!!

  4. #4
    Default CPT Code 15430 - 15431 used for "Wound Care"
    There are some LCD's that states CPT code 15430 - 15431 "will not be paid no more frequently than at 90-day intervals." Will the 58 modifier be appropriate to add for re-applications of a Skin Substitute within a 90 day interval?

    Note: Treatment of any ulcer will typically last no more than twelve (12) weeks.
    The treatment/skin substitute may be applied twice a week within a twelve week period before improvement is seen.

  5. Default
    I have the same question regarding application of biologic wound dressing (15430). Can we use the 58 modifier with each application?

    Vicky

  6. Default confused :(
    patient had a deep thigh hematoma that was treated on June 1st by incision and drainage; cpt 27301 was billed. patient went home, but developed fever and swelling, came back to the hospital and had another 27301 performed on June 7th by the same surgeon. modifier 78 was applied to the June 7th procedure, my question is simply because modifier 78 does not reset the global period, does that mean the June 7th procedure does not get one at all as a 27301 is a 90 day global procedure? Any help would be appreciated, I just want to make sure I'm not giving our patients the wrong information and ending their global periods too soon. Thanks!

  7. Default
    Quote Originally Posted by asdaines View Post
    patient had a deep thigh hematoma that was treated on June 1st by incision and drainage; cpt 27301 was billed. patient went home, but developed fever and swelling, came back to the hospital and had another 27301 performed on June 7th by the same surgeon. modifier 78 was applied to the June 7th procedure, my question is simply because modifier 78 does not reset the global period, does that mean the June 7th procedure does not get one at all as a 27301 is a 90 day global procedure? Any help would be appreciated, I just want to make sure I'm not giving our patients the wrong information and ending their global periods too soon. Thanks!
    Modifier 78 ties that return to the OR to the original procedure, so it does not restart the global period nor does it create a new one because of the relationship between the return to the OR and the original procedure - because it's a complication. The key is that it has to be complication, the documentation has to clearly indicate it's a complication, and that it required a return to an actual OR. And as previously mentioned, the reimbursement is reduced.

Similar Threads

  1. Modifier 76 & global period
    By PMiklavcic in forum Modifiers
    Replies: 4
    Last Post: 07-31-2012, 12:28 PM
  2. Medicare Modifier for Global Period
    By rksaleh in forum Modifiers
    Replies: 5
    Last Post: 07-29-2012, 06:10 AM
  3. 24 modifier global period
    By willette in forum Medicare Regulations
    Replies: 1
    Last Post: 03-23-2012, 08:52 AM
  4. Modifier during global period?
    By cmac in forum Family Practice
    Replies: 2
    Last Post: 05-08-2009, 08:12 AM
  5. E/M With Modifier 24 During Global Period
    By MBA101 in forum ENT/Otolaryngology
    Replies: 7
    Last Post: 03-25-2008, 12:15 PM

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?

Login

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.