58 or 79??

One of our physicians documented in March 2011 he was going to do a bilateral knee arthroplasty, starting with the left knee, followed 6 weeks later with the right knee. A modifier was inadvertantly left off of the second TKA, so it was denied as it was still in the global period from the first TKA. We are going to appeal, putting in a modifier. Question is: modifier 58 since it was originally documented that both knees are going to be done, or modifier 79 since it was the opposite knee from the first TKA? Thank you.
EGuest

re: 58 or 79??

-79 unrelated to the other knee surgery. Just because he says in his notes he's going to do both knees, you bill and add modifiers based on the actual procedure done at the time, not what he is going to do in the future. So the rt knee was done, that's over with and patient is in global. Now he's going to do the left knee which is unrelated to the right knee surgery so -79 applies.