Modifiers: 58, 78, 79
Question:
Can KZA please explain global modifiers (58, 78, 79)?
Answer:
Excellent question. Modifiers 58, 78, and 79 are used when a patient is in a global period following a prior procedure. Each modifier signals a specific circumstance to the payer, impacting reimbursement and compliance. Here is how they differ:
Modifier 58 - Staged or Related Procedure
Used when:
Planned or anticipated (staged);
More extensive than the original procedure; or
Therapy is provided following a surgical procedure.
Key Points:
Resets global period.
No payment reduction.
Example: Removal of remaining thyroid tissue for completion thyroidectomy in the global period after a partial thyroidectomy (60260-58).
Takeaway: The procedure is more extensive, planned, or anticipated.
Modifier 78 - Unplanned Return to the Operating/Procedure Room
Used when:
The patient returns to the OR for an unplanned procedure related to the initial surgery.
Key Points:
No change to the global period.
Payment reduction.
Example: Patient returns to the OR following a tonsillectomy for a tonsillectomy bleed (42962-78 – Control of oropharyngeal hemorrhage; with secondary surgical intervention (typically return to the OR for operative control of bleeding).
Takeaway: The procedure performed involves an unexpected return to the OR for a related procedure – typically a complication.
Modifier 79 - Unrelated Procedure or Service
Used when:
Unrelated Procedure or Service.
Key Points:
Resets global period.
No payment reduction.
Example: A patient is seen at the first post-op visit 4 days after a tympanoplasty (10 day global) and now complains of hoarseness likely due to the endotracheal tube used for anesthesia. You perform a flexible laryngoscopy (31575-79, you may also want to record 99024 for the post-op visit though it of course has a $0 charge).
Takeaway: The procedure is entirely unrelated to prior surgery.
Thank you for reaching out to KZA with your inquiry!
*This response is based on the best information available as of 09/10/26.
