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Modifier Needed?

  1. #1
    Location
    Greater Pittsburgh Chapter
    Posts
    14
    Default Modifier Needed?
    Medical Coding Books
    One of our surgeons performed an I&D CPT 10060 with diagnosis 527.2 on a patient in the hospital. Patient was discharged and then four days after the initial procedure, presented again with a recurrence of the abscess.

    Another surgeon in our practice then performed CPT 21501 with diagnosis 682.1 four days after the initial procedure. Do I need to use modifier 78 or perhaps 79? Do these modifiers apply when another surgeon in the group performs the second procedure since we bill under the group NPI?

    Thank you,
    Beverly

  2. #2
    Location
    Stuart Sailfish Chapter
    Posts
    867
    Default
    Hi Beverly. Im not with my books. but the modifer usage will depend on the global that is on the initial procedure, and as far as the other physicians in your practice. you will still need to append a modifier, as long as you bill under the "group".

    Hope this helps
    Candice Fenildo, CPC, CPMA, CPC-I, CPB, CENTC, CRHC, AAPC Fellow
    AAPC Chapter Association Board of Directors ( Chair)
    Region 6, Wisconsin, Minnesota, Illinois, Indiana, Michigan, Ohio
    772-342-6976
    Candice.Fenildo@appcca.org

    "Nothing is stronger than the heart of a volunteer"

  3. #3
    Location
    Tuscaloosa, AL
    Posts
    92
    Default
    I would use modifer 58 - staged/related procedure during the postop period MORE EXTENSIVE THAN THE ORIGINAL PROCEDURE.
    Jerri, CPC

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