E/M Coding Alert - 2008 Issue 12
Reader Questions: Modifier 78 Won't Provide Total Reimbursement
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Article Overview
This reader Q&A discusses reimbursement implications tied to a postoperative surgical modifier and explains why payment may differ from the full fee schedule amount. It is relevant for coders, billers, and revenue cycle staff who work with surgical claims, postoperative periods, and payer payment policies under CPT-based fee schedules.
Why This Topic Matters
Understanding the general reimbursement impact of this modifier helps prevent incorrect expectations about payment and supports more accurate claim review and follow-up.
What You Will Learn
- How a postoperative surgical modifier can affect reimbursement
- Why payment may differ from the full fee schedule amount
- How the global period is affected in broad terms when this modifier is used
- What general factors influence the reimbursed portion of the service
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Surgical practice administrators
Modifiers Discussed
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