Does 78 modifier reduce payment?
Use of modifier 78 results in a payment reduction based on the individual payer’s fee schedule.
Use of modifier 58 will result in full payment.
The subsequent procedure is unplanned.
The subsequent procedure is planned or staged or is more extensive than the initial procedure..
Can modifier 78 be used in an office setting?
Modifier 78 can be appended only if procedure is in an operating room; modifier 79 does not require that the service/procedure be performed in an operating room.
What is modifier 57 used for?
Modifier 57 Decision for Surgery: add Modifier 57 to the appropriate level of E/M service provided on the day before or day of surgery, in which the initial decision is made to perform major surgery. Major surgery includes all surgical procedures assigned a 90-day global surgery period.
What is modifier 76 used for?
Instructions. Used to indicate a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service.
What is the difference between modifier 58 and 78?
Modifier 58 and modifier 78 are often mixed up, because both refer to related procedures by the same physician in the post-operative period. However, modifier 58 generally describes staged/planned procedures, while modifier 78 is used for unexpected procedures.
What is a requirement for reporting modifier 78?
Modifier 78 is used to report an unplanned return to the operating or procedure room, by the same physician, following an initial procedure for a related procedure during the post-operative period.