What does modifier 78 indicate?
Modifier 78 is used to report the unplanned return to the operating/procedure room by the same physician following an initial procedure for a related procedure during the postoperative period.
What is a requirement for reporting modifier 78?
Use modifier 78 for “Unplanned return to the operating or procedure room by the same physician following initial procedure for a related procedure during the post-operative period.” The gist of that is, choose modifier 78 for a related operation that wasn’t planned in advance. For example, a surgeon does a biopsy.
How does modifier 78 affect reimbursement?
Modifiers 78: To indicate that a complication of an original procedure was treated by a return to the operating room, catheterization or endoscopy suite. Reimbursement should be at 70-80% of the allowable fee.
Does modifier 78 extend global period?
Modifier 78 allows for the intraoperative percentage only of major or minor procedures (010 or 090 global periods).
When can you use modifier 78?
When to Use Modifier 78. Use modifier 78 for “Unplanned return to the operating or procedure room by the same physician following initial procedure for a related procedure during the post-operative period.” The gist of that is, choose modifier 78 for a related operation that wasn’t planned in advance.
Can modifier 78 be used in an office setting?
Unlike modifiers 58 and 79, 78 may not be performed anywhere but in the O.R. or the endoscopy suite.
Does 78 modifier reduce payment?
Use of modifier 78 results in a payment reduction based on the individual payer’s fee schedule. Use of modifier 58 will result in full payment. The subsequent procedure is unplanned. The subsequent procedure is planned or staged or is more extensive than the initial procedure.
Can modifier as and 78 be used together?
CPT modifiers 50 and 78 cannot be submitted for the same service. Instead, submit the surgery procedure code with CPT modifier 78 and HCPCS modifier RT on one detail line, and submit the same surgery procedure code with CPT modifier 78 and HCPCS modifier LT on a separate detail line.
Can modifier 78 and 79 be used together?
Modifiers 58, 78, and 79 are all used in conjunction with procedures performed within the global period of another procedure.
When do you use the modifier 78 for surgery?
Modifier 78 allows for the intraoperative percentage only of major or minor procedures (010 or 090 global surgery indicators). A new postoperative period does not begin when using modifier 78.
What is the meaning of the modifier 58?
Staged or anticipated procedures (modifier 58) are a very specific type of related procedures. Documentation that the subsequent procedure was a staged or anticipated procedure of the original surgery may be included in the operative report for the original surgery or the preoperative documentation.
Which is the correct modifier 79 or 79?
Both modifiers describe a return to the OR during the global period of another procedure, but modifier 79 indicates the subsequent procedure is unrelated to the initial surgery. In other words, the follow-up procedure is not a result of the initial surgery or the diagnosis that prompted it.
What are the modifiers for a procedure code?
Modifiers Used with Procedure Codes. 1 26: Professional Component. 2 TC: Technical Component. 3 99: Multiple Modifiers. Explain in the Remarks area/Additional Claim Information(Box 19) of the claim form. For further information about billing