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Modifier -78 or -58

  1. #1
    Default Modifier -78 or -58
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    I am in need of some help trying to bill these (2) seperate, but related procedures to a commercial insurance (United Health Care) ? The patient was brought in for a missed abortion and a D&C was performed with a cpt code of 59812. Then 2 days later, the pt was brought back for a ruptured left ectopic pregnancy. The procedure was a laparoscopy and left distal salpingectomy by the same physician with a code of 59151-LT. Should modifier -78 be appended to the 2nd procedure since it was unplanned and it was only 2 days after the 1st procedure? or is -58 is right one since it is related and more extensive?

    Any help is greatly appreciated. Confused

    Ruth, CPC

  2. Default
    In my opinion mod 58 would be a better code of choice. Mod 78, in my opinion, is used for "complications", however it's usually a complication of the procedure. Mod 78 possibly can be the modifier, if the D&C caused the rupture of the ectopic pregnancy.......I was kind of thinking about mod 79...Well, I'm curious to see the opinions of others. Good luck!

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