Can modifier 58 be used in the office?

When the patient presents in the office for stent removal, a 52310 Cystourethroscopy, with removal of ureteral stent with modifier 58 can be billed out.” In this case, the “follow up” procedure is both planned prospectively and more extensive to the original procedure.

Can modifier 58 and 59 be used together?

If a better modifier exists, use it. In some cases, coders will append modifier -58 (staged or related procedure or service by the same physician during the postoperative period) instead of modifier -59.

Does modifier 58 affect payment?

Modifier 58 should not alter the amount charged or paid for subsequent unrelated or staged procedures that are performed during the postoperative period of a previous procedure. Modifier 78 may drive a reduction because it is for management of a complication resulting from the previous procedure.

When can I use modifier 58?

When to Use Modifier 58. Modifier 58 is used for a “staged or related procedure or service by the same physician during the post-operative period.” Further, according to CMS.gov, modifier 58 indicates that the procedure was: Planned, either at the time of the first procedure or prospectively.

What replaced modifier 59?

Medicare recently announced they’ve established four new modifiers – XE, XS, XP, and XU – that may be used in lieu of modifier 59. The codes are more specific and become effective January 1, 2015.

What is the meaning of the modifier 58?

Modifier 58. Modifier 58 Staged or related procedure or service by the same physician during the postoperative period may be necessary to indicate the performance of a procedure during the postoperative period was: Planned prospectively at the time of the original procedure, or “staged;” “More extensive” than (that is,…

When to use the 58 modifier in CareCloud?

Modifier 58 is a surgical-specific modifier, used to indicate a staged or related procedure or service by the same physician during the postoperative period.

What is the modifier 78 for unexpected surgery?

The unexpected surgery/procedure does not reset or begin a new global period. Modifier 78 is a payment modifier and the payment for procedures reported using this modifier will be 70 or 80 percent of the physician fee schedule for the surgical procedure.

Why are skin grafts billed with CPT modifier 58?

Because the surgeon knew the biopsy might result in a further, more extensive procedure, pending test results. A surgeon performs a procedure to debride a sacral ulcer. During the procedure, the surgeon knows she must perform a skin graft on the ulcer site at a later date. The skin graft will be billed with modifier 58. Why?