Modifier 58 vs. Modifier 78

Modifier 58 vs. Modifier 78

March 18, 2021

Question:
Do some insurance carriers want modifier 58 and others want 78?  What is the difference in these modifiers?

Answer:
Modifier 58 is used on a subsequent surgery when a planned (or staged) related procedure is performed within the global period of the first surgery. If possible, but not required, the surgeon should document within both operative notes (the initial surgery and subsequent surgery) to indicate the procedures are staged. It is also used when a more extensive procedure, related to the first, is performed during the global period.

Modifier 78 is used on a subsequent surgery when an unplanned related procedure, typically a complication, is performed within the global period of the first surgery.

*This response is based on the best information available as of 3/18/21.

REGISTER NOW

NEW
ON-DEMAND WORKSHOPS

AVAILABLE

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches