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Modifier 58

  1. Default Modifier 58
    Medical Coding Books
    I am trying to get clarification on the scenerio below:

    Our Doctors are in the same group practice, different specialties and bill under the same tax ID number.

    The plan of care is as follows: Patient has an endoscopic CABG (LIMA to LAD) than 3 days later goes to the Cath lab for PCI of 2 different vessels. Can we use a modifier 58. The CABG has a 90 day global period. Everything I am reading states staged procedure by the same physician or different physician within the group practice but same specialty.
    CT Surgeons and Interventional Cardiologists are not the same specialty. I need some clarification please how the above scenario can be billed.
    Any help would be greatly appreciated.
    Thank you

  2. Default
    Have you looked at -79(Unrelated Procedure or Service by the Same Physician During the Postoperative Period)? I have a general surgery clinic that has multiple sub specialties within it and I have this problem all the time.

    Kelsey, CPC

  3. #3
    Milwaukee WI
    Default Different specialty?
    If it's a different doctor with a different specialty you should not need any modifier.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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