Carotid Endarterectomy Performed Bilaterally On Different Dates

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Question:

We are having a debate in our office. The surgeon performed a right carotid endarterectomy on a patient and then brought the patient back to do the left carotid 2 weeks later. I know a modifier is needed on the second procedure since endarterectomy has a 90 day global. Would a 58 modifier be the appropriate modifier?

Answer:

Although it was known in advance that the left carotid would be done in a “staged” approach following the right, the more appropriate modifier is a 79, unrelated procedure. The right carotid surgery is performed at a different operative site and is unrelated to the surgery performed on the left.