tci Part B Insider - 2004 Issue 16

Modifiers: Use -58, Not -78 When Open Reduction Follows Closed

Document that the physician discussed risks the first timeWhen you're providing global fracture care, the patient sometimes may require extra treatment that goes beyond what's covered in the global period. There's some controversy over what to do when the physician performs a closed reduction of a fracture, then two weeks later, the fracture slips and the physician must perform an open reduction of the same fracture. In that circumstance, many coders advocate the -78 modifier (Return to the operating room for a related procedure during the post-operative period). But others point to the -58 modifier (Staged or related...

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