Modifier 58 Staged or Related Procedure or Service During Postoperative Period by Same Physician ![]() Guideline: The same physician planned, at time of original surgery/procedure, a return trip to operating or procedure room within 10 or 90 day post op days WHEN IT IS APPROPRIATE:
Physicians in same specialty, same group are to bill and are reimbursed as a single physician Key to Remember! Use modifier 78 (not 58!) for treatment problems unplanned requiring return trip to operating room If hardware removed in unplanned surgery return for a complication, (e.g. infection of the wound site or rejection of the hardware itself), modifier 78 appropriate It is NOT APPROPRIATE WHEN:
References:
CMS Medicare Website Coding Books Payers Websites
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![]() ABOUT THE AUTHOR:
Ms. Pinky Maniri-Pescasio is the Founder of GoHealthcare Consulting. She is a National Speaker on Practice Reimbursement and a Physician Advocate. She has served the Medical Practice Industry for more than 25 years as a Professional Medical Practice Consultant. search hereArchives
August 2023
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