A physician performs a breast biopsy for a suspicious lump. The results of this biopsy will determine if the surgeon will progress with further resection or conclude the procedure. The physician awaits the intraoperative results before proceeding. What modifier is assigned to the biopsy code?

Question

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Modifier -58 is used when a procedure is planned or staged, and a subsequent procedure is performed during the same session or after the healing period. In this case, the biopsy is considered a planned or staged procedure because the physician is awaiting the results before deciding whether to proceed with further resection. Therefore, modifier -58 is appropriate. Modifier -59 is used for a distinct procedural service that is not normally bundled together, -57 is used for decision for surgery, and -52 is used for reduced services.

A Physician Performs a Breast Biopsy for a Suspicious Lump