Procedure

“I have a patient who had a hammer toe deformity, and this required repair of the second toe. Unfortunately, the surgical site developed osteomyelitis. This complication occurred at postoperative week number four. I returned to the operating room to perform an amputation of the second toe because of osteomyelitis. I would like to hear thoughts on the appropriate modifiers. And how does the zero-day global period for the amputation play into the billing for the post operative care?”

“I performed a partial 1st ray amputation that included the hallux and part of the 1st metatarsal. The site did not heal, and a new infection developed at the amputation site. The result is a return to the operating room for a right trans-metatarsal amputation. For the subsequent surgery, I used Modifier 78. After all, this was an unplanned return to the operating room. I evaluated the patient post operatively and I am wondering which date should I be using for the 90-day global period?”