tci Medicare Compliance & Reimbursement - 2007 Issue 24

MODIFIERS: How 'Unrelated' Is 'Unrelated To The Original Surgery'?

When you should use the 79 modifier for post-operative issues. Although many providers are tempted to use the 78 modifier for post-operative complications, they may be wrong--and could face a denial. You should use modifier 79 to report an unrelated procedure or service by the same physician during the postoperative period, says Maxine Lewis with Medical Coding Reimbursement Management in Cincinnati. It's pretty unusual that a complication of a procedure wouldn't be "directly related to the original procedure." Complications such as infection, hemorrhage or dehiscence are all complications of the original surgery. They "may require additional services, but...

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