Can you use modifier 58 and 78 together?
Asked by: Wendell Armstrong | Last update: August 25, 2025Score: 4.8/5 (25 votes)
Can modifier 58 and 79 be used together?
A new global period does begin with the second procedure in this case, and the procedure is usually reimbursed at 100% of the amount allowed by the payer. 2. Modifier 79 should not be used along with modifier 58 or 78.
When to use modifier 58 vs 78?
We typically look to modifier 58 to indicate an expected return to the operating room to complete a procedure in stages. By contrast, we look to modifier 78 if the return to the operating room is unplanned. But an unplanned return to the procedure room may still call for modifier 58.
Can you use two modifiers on one CPT code?
CPT modifiers are added to the end of a CPT code with a hyphen. In the case of more than one modifier, you code the “functional” modifier first, and the “informational” modifier second.
Which modifier goes first, 78 or 59?
If you have two pricing modifiers, the most common scenario is likely to involve 26 and another modifier. Always add 26 before any other modifier. If you have two payment modifiers, a common one is 51 and 59, enter 59 in the first position. If 51 and 78, enter 78 in the first position.
Modifier 58 and 78 differentiation
Can you use modifier 59 and 76 together?
If Modifier 76 is included in the medical claim, then it is considered invalid if used with Modifier 59. Modifier 59 refers to procedures or services completed on the same day that is because of special circumstances and are not normally performed together.
Why is the 78 modifier used?
Current Procedural Terminology (CPT®) modifier 78 is used to describe an unplanned return to the operating room or procedure room during the global period of the initial procedure by the same physician.
What are the two types of modifiers that can be combined?
Modifiers give additional information about nouns, pronouns, verbs, and themselves to make those things more definite. There are two types of modifiers: adjectives and adverbs.
What is the correct order for modifiers?
In medical coding, modifiers are used to give additional information about a procedure, service, or supply, and modifiers that will have the biggest impact on reimbursement are normally sequenced first. These modifiers typically fall into one of three categories: (1) Pricing, (2) Payment, or (3) Location.
What is the modifier 59 rule?
For the NCCI, the primary purpose of CPT® modifier 59 is to indicate that two or more procedures are performed at different anatomic sites or during different patient encounters. It should only be used if no other modifier more appropriately describes the relationships of the two or more procedure codes.
Which scenario qualifies for modifier 58?
In surgical situations when a subsequent procedure takes place within the global period of the original procedure, and/or because the physician anticipated a planned (or staged) procedure, modifier 58 comes into play.
How do you know if a CPT code needs a modifier?
- The service or procedure has both professional and technical components.
- More than one provider performed the service or procedure.
- More than one location was involved.
- A service or procedure was increased or reduced in comparison to what the code typically requires.
Does 58 modifier restart global period?
Modifier 58=The global period restarts with the subsequent procedure, and the surgeon should receive 100 percent of the allowable reimbursement on both the first and the subsequent procedures.
What is the proper use of modifier 58?
Modifier 58. Modifier 58 Staged or related procedure or service by the same physician during the postoperative period may be necessary to indicate the performance of a procedure during the postoperative period was: Planned prospectively at the time of the original procedure, or “staged;”
How much does modifier 78 reduce payment?
*The 20 % refers to a reduction of payment on claims submitted with Modifier 78.
Can you use modifier 59 and RT together?
Don't add modifiers 59, XE, XS, XP, XU to either code to report 2 procedures for the same side of the body. If you performed 2 procedures on different sides of the body, you may report them with modifiers LT and RT as appropriate.
What are the rules for modifiers?
Your modifier must modify a word or phrase that is included in your sentence. If you do not include this word or phrase in your sentence, you create a dangling modifier error.
Does order of modifiers matter?
Answer: Yes. The payment modifier should be placed first and then any informational modifiers follow. A payment modifier example is -58, -79. These modifiers tell the payer why a surgery should be paid a certain way.
Which modifier is used to show multiple modifiers?
Modifier 51 Multiple Procedures indicates that multiple procedures were performed at the same session. It applies to: Different procedures performed at the same session.
When using multiple modifiers in what order are they sequenced?
The proper sequencing order for modifiers is as follows: 1) pricing, 2) payment, and 3) location. Location modifier is always reported last in any coding scenario. Modifiers 26 and TC are examples of pricing modifiers while modifiers 51 and 59 are examples of payment. RT and LT are examples of location modifiers.
How do you place modifiers correctly?
A modifier is a word or phrase that describes or clarifies another word or phrase in a sentence. The placement of modifiers is important for clear and accurate communication. In English, modifiers should be placed as close as possible to the word or phrase they're modifying to avoid confusion.
What is the difference between a specifier and modifier?
Access Specifier is used to provide your code in Java whether other classes can access your code or not. Access Modifier provides both Access Specifier and Access Modifiers for creating access to your Java code for other classes.
What is the 58 78 79 modifier?
Modifiers 58 and 78 are always for procedures related to another procedure. With modifier 79, it doesn't matter whether the procedure was planned or unplanned during the previous procedure, because there's no connection between the different operations.
What is the difference between modifier 59 and 78?
Modifier 59 refers to a non-E/M service performed on the same day. In comparison, modifiers 79, 78, and 58 refer to unrelated procedures or E/M services performed post-op. However, the point of confusion is usually regarding modifier 79.
What situation is modifier 59 most commonly used for?
For example, Modifier 59 should be used when coding for a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion (noncontiguous lesions in different anatomic regions of the same organ), or separate injury.