tci Part B Insider - 2011 Issue 8

Reader Questions: Planning Determines Difference Between Modifiers 58, 78

Question: In December, a patient had extracorporeal shock wave lithotripsy, which carries a 90-day global. This was for a ureteral stone. The patient returned in February with pain and an x-ray showed the stone unchanged in the ureter. Therefore, the urologist performed a ureteroscopy and stone extraction. I billed this to the insurance with a 58 modifier, but it is being denied. How should I be coding instead? Answer: You are still in the 90-day global of the extracorporeal shock wave lithotripsy (ESWL), but you are now providing a more invasive surgical procedure. Your coding for the treatment of...

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