Studying for test....if the question states that a patient had a previous surgery on left foot 15 days ago. Now today the same dr. Is doing a different surgery on his right leg, would the code have a modifier 79? It didn't state that it had anything to do with the reason for the first surgery, but the practice test said to put mod 79' why?
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Q&A Mod 79
- Thread starter Lisa Berry
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Laureen
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Blitzer
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It's because it is the same surgeon working on same patient. The payor assumes it is related to first procedure. Yes the fact that it is a different side should tell the story but they don't look at that (at least they have not trained the computers to do that for them). But they do train the computers to consider the modifiers. Modifier 79 unlocks the door and gets the claim in and puts the burden on the physician to provide proof if audited.
