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Modifier Needed?

  1. #1
    Greater Pittsburgh Chapter
    Default Modifier Needed?
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    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,

  2. #2
    Stuart Sailfish Chapter
    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
    Director of Operations
    Ear, Nose and Throat Associates of South Florida, PA

    "Nothing is stronger than the heart of a volunteer"

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

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