AMA CPT® Assistant - 2008 Issue 2 (February)
Modifiers 58 and 78 (February 2008)
February 2008 pages 3-6 Coding Clarification: Modifiers 58 and 78 The CPT modifiers provide the means to report or indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition. Because modifiers also enable health care professionals to effectively respond to payment policy requirements established by other entities, for CPT 2008 , the descriptor language of the CPT modifiers 58 and 78 was revised. The revisions are intended to clarify the use of these modifiers and to avoid restricting usage by designated providers as defined by payment programs...
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Article Overview
This premium article reviews the February 2008 CPT clarification on modifiers 58 and 78. It explains why the descriptor language was revised, how the changes relate to postoperative and related procedures, and how the guidance is framed for different provider types and payer policies. The article also includes commonly asked questions about applicability in specific code families and discusses the broader reporting context for CPT users, coders, and reimbursement staff.
Why This Topic Matters
The revisions affect how coders interpret and report postoperative related procedures under CPT and payer payment policies. Understanding the update helps coding and billing teams align reporting practices with current descriptor language and avoid misapplication of these modifiers.
Article Sections
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Coding Clarification: Modifiers 58 and 78
Overview of the CPT clarification and the reason for revising the modifier descriptor language in relation to payer policy and provider categories.
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Why Use Modifier 58?
Background on the modifier’s historical purpose and the reimbursement context in which it is used.
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Coding Tip
A brief payer-related note about general acceptance of the modifier in certain global period situations.
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Why Use Modifier 78?
Background on the modifier’s role in reporting related postoperative services and the distinction from the other modifier discussed in the article.
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Coding Tip
A brief reference defining the operative setting terminology used in relation to postoperative reporting.
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What Has Changed for Modifier 58?
Discussion of the revised descriptor language and the general reasons for the wording changes affecting reporting scope.
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What Has Changed for Modifier 78?
Discussion of the revised descriptor language and the general reasons for the wording changes affecting reporting scope.
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Commonly Asked Questions
Frequently asked questions covering the applicability of the modifiers in selected CPT code groups and the CPT Editorial Panel’s perspective.
What You Will Learn
- The historical purpose of CPT modifiers 58 and 78
- Why the 2008 descriptor language was revised
- How the article frames postoperative reporting and payer policy considerations
- The kinds of questions addressed about modifier applicability in selected CPT code groups
Who Should Read This
- Medical coders
- Coding educators
- Billing and reimbursement staff
- Physician practices
- Facility coding teams
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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