Modifier 58 is used primarily for what purpose?

Modifier 58 is specifically designed to indicate that a surgical procedure is either staged or related to a previous procedure that was performed during the postoperative period. This modifier helps convey to payers that the subsequent procedure has a logical and medically necessary relationship to the prior surgery, ensuring appropriate reimbursement and clear documentation of patient care.

When a surgeon plans for a staged procedure—meaning that the follow-up surgical intervention is a planned, separate procedure—it is crucial to use Modifier 58 to inform insurers that this is part of a broader treatment plan rather than an unrelated event. This could include cases where a secondary surgery is done in a sequence to address a surgical condition or complication resulting from the initial procedure.

The other options do not accurately describe the primary use of Modifier 58. It does not necessarily indicate a change in surgical techniques, nor does it replace Modifier 57; instead, Modifier 57 indicates an unplanned surgical decision within the preoperative period. Lastly, Modifier 58 does not pertain to procedures performed outside the postoperative period, which could involve different modifiers altogether. Thus, Modifier 58's primary function in billing and documentation is to support the relationship of the procedures within a surgical context.