Modifier -58
Compliance Monitor, March 22, 2006
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Are you being paid properly for postsurgical procedures? Using modifier -58 ensures that your facility will receive all of the reimbursement it deserves, says Lolita Jones, RHIA, CCS, of Lolita M. Jones Consulting in Fort Washington, MD, in the HCPro, Inc., book The Modifier Clinic: A Guide to Hospital Outpatient Challenges.
Report modifier -58 to indicate the performance of a staged or related procedure/service by the same physician during the postoperative period.
"For example, a scheduled diagnostic procedure might be performed in the morning, resulting in the decision by the surgeon to perform an unscheduled therapeutic procedure on the same patient later on the same day," Jones says.
Report modifier -58 for a procedure or service that is
"Because hospital outpatient reporting represents services performed within a given 24-hour period or a range of dates, the original intent and use of modifier -58 is not altered for hospital outpatient reporting," Jones says.
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