tci General Surgery Coding Alert - 2009 Issue 15

Document 'Unrelated' for Modifier 79 Services

MACs looking for 'red flag' to halt additional global period pay. Billing for additional services during a global surgery period is always tricky, but now you can expect special scrutiny for modifier 79 claims. After the OIG got wind of fraudulent surgery billing with modifier 79 (Unrelated procedure or service by the same physician during the postoperative period), CMS contractors have been on the hunt for modifier 79 abuse. Implement our expert tips below to keep your 79 claims clean. Obey Global Package Model The starting point for clean modifier 79 claims is not breaching the global surgical billing...

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