79 - JF Part B
Unrelated procedure or service by the same physician during the postoperative period.
This modifier is used when an unrelated procedure or service, by the same physician, is performed during the postoperative period (10 or 90 day global) of the original procedure. A new post-operative period begins when the unrelated procedure is billed.
- Only on surgical codes
- Append modifier 79 in first position as pricing modifier
- Not necessarily needing return to operating room
- Failure to append could result in noncoverage
- For repeat procedures on same day, append modifier 76
- If Medicare Physician Fee Schedule (MPFS) indicator list marked with "XXX," no modifier is needed as there are no global dates
Claim Coding Example
- Provider performs right toe amputation on May 24, 2015.
- On June 25, 2015, a left foot amputation surgery was medically necessary within this 90 day global period
|5/24/15||Amputation big toe, RT||28820 TA|
|6/25/15||Amputation foot, LT||28800 79|
- CMS Internet Only Manual (IOM), Medicare Claims Processing Manual, Publication 100-04, Chapter 12, Sections 30 and 40.2
Last Updated Tue, 25 Oct 2022 15:15:55 +0000