9/25/18 – Stay Away from Modifier 58 on Anesthesia Claims

Question: Is it appropriate to use modifier 58 on anesthesia encounters when the surgeon plans to return to the OR for a stage procedure?

Answer:  No, that is not allowed because global surgery modifiers are not appropriate for anesthesia.  According to the CPT definition, modifier 58 represents a “Staged or related procedure of service by the same physician during the post-operative period”.  It would only be appropriate for use by the surgeon doing the procedure if they are within the global period of a surgery that they themselves performed.  Modifier 58 is not for use on anesthesia CPT codes, or by the anesthesiologist since that is a different provider of a different specialty.

 

 

Also, the global surgery rules indicate that “services of other physicians related to the surgery” are excluded from the global surgery package. By extension there would be no reason to append a modifier to an anesthesia service.


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