Modifier clarification

Can modifier 79 be used on 36561 (port placement for chemo) when billed during the global for a mastectomy (90 day global). I would think that modifier 58 would be the appropriate modifier here but my coder says differently. I've read as many articles as I can find on this subject, but it's still a little ambiguous to me. Is there anyone who can help clarify this for me?

Also, the coder is appending modifier 24 to E&M codes billed during postop due to post op infections or complications. I'm pretty sure this is a big no-no with Medicare, but any help here would be appreciated.

Re: Modifier clarification

I use a 79 on my port placements when needed. The reason I don't use 58 or 78 is that they mention a related "procedure"....While the port is related to the same diagnosis, it's a completely different area/procedure. I've never had a denial.

As for the 24 being put on the OV's, yes this is a big no-no with Medicare. Unless the complication took you back to the OR, Medicare doesn't want to hear about it...it's inclusive to their global surgical package. Google "medicare surgical package" for more info.

Now, some of the commerical payers may be a bit more lenient....and they may pay...but for the most part we choose to avoid confusion and follow Medicare guidelines.