What modifier should be used to report a mastectomy after a biopsy during the global period?

The correct modifier to report a mastectomy after a biopsy during the global period is the -58 modifier. This modifier indicates that the surgical procedure (in this case, a mastectomy) is a staged or related procedure performed during the global period of a previous procedure (the biopsy).

By using the -58 modifier, you are signaling to the payer that this is a planned procedure that is part of the treatment process following the initial biopsy and that it was appropriately scheduled according to the patient’s healthcare needs. It clarifies that the mastectomy is not a complication or an unexpected outcome from the biopsy, but rather a continuation of care that should be reimbursed separately from the biopsy.

Modifiers like -56, -28, and -78 serve different purposes. For example, -56 is used to indicate a pre-operative period when a service is provided that is related to the later surgical procedure but does not denote that it’s related to a prior procedure. The -28 modifier is used for distinct procedural services and is not applicable here as it generally pertains to the reporting of related procedures performed on the same day. The -78 modifier indicates a return to the operating room for a related procedure during the postoperative period, which does not apply in this