What is a 57 modifier used for?
Modifier 57 Decision for Surgery: add Modifier 57 to the appropriate level of E/M service provided on the day before or day of surgery, in which the initial decision is made to perform major surgery. Major surgery includes all surgical procedures assigned a 90-day global surgery period.
Does the global period start over with modifier 58?
Modifier 58=The global period restarts with the subsequent procedure, and the surgeon should receive 100 percent of the allowable reimbursement on both the first and the subsequent procedures.
What is the difference between modifier 58 and 78?
Modifier 58 and modifier 78 are often mixed up, because both refer to related procedures by the same physician in the post-operative period. However, modifier 58 generally describes staged/planned procedures, while modifier 78 is used for unexpected procedures.
How does modifier 58 affect reimbursement?
Modifier 58: to indicate a second procedure was performed as a staged procedure. Reimbursement should be 100% of the allowable fee. Modifier 79: To indicate an unrelated procedure was performed during the global period of the original procedure. Reimbursement should be 100% of the allowable fee.
Is the 30520 code a 90 day global?
Unfortunately, I am finding that BCBS is only wanting to pay for one when my physician usually does 2-3 postoperatively. The 30520 is the only code with a 90 day global so you would attach a 79 modifier to the code. I would also suggest precerting it when you precert the actual surgery.
What is the CPT modifier for 0000 global days?
CPT modifier 25: The E/M service was performed on the same day as a minor surgery (000 or 010 global days) is significant and separately identifiable from the usual work associated with the surgery. Documentation in the patient’s medical record must support the use of this modifier.
When do you not use the Global Surgery modifier?
This modifier is not used with minor surgeries because the global period for minor surgeries does not include the day prior to the surgery.
Which is the correct global period for surgery?
Modifier 57 Decision for surgery is similar to modifier 25, except that the surgical package includes one day prior to the procedure and usually has a 90-day global period after the procedure.