Surgeons: Are you using your Modifiers?

Even though there is a global period for most minor and major procedures you still can bill for certain services by reporting them with the appropriate modifier.  

Important Modifiers for Surgeons are:

Modifier 25– If you see a patient for a new problem and that visit results in the decision to perform a minor procedure (10 day global) bill the E/M code with the 25 modifier.

Modifier 57– If you see a patient for a new problem and that visit results in the decision to perform a major procedure (90 day global) bill the E/M code with the 57 modifier.

Modifier 78– An unexpected return to the operating room during the post operative period even if it is related to the original procedure can be reported with a 78 modifier.    The procedure will be paid at 70-80% of the allowable.  

Modifier 79– An unrelated procedure during the post operative period should be reported with a 79 modifier.   This procedure should be paid at 100% of the allowable. 

Modifier 58– A planned or staged procedure during the post operative period should be reported with a 58 modifier.  This procedure should be paid at 100% of the allowable.

Be sure to use your modifiers to get the payment you deserve for payment during the post operative period. 

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