Gastroenterology Coding Alert

Question: My gastroenterologist placed a gastrostomy tube. Then, the tube leaked eight days later so the physician sent the patient back to the operating room (OR) and then changed the tube. Should I append modifier 78 or 58 to the tube change code (43760)? Arizona SubscriberAnswer: You don't need a modifier in this case. Code 43760 (Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance) has zero global days so there is no global period. Therefore, you do not need modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) or modifier 78 (Unplanned return to the operating room following initial procedure for a related procedure during the postoperative period) for this procedure.Warning: Be especially careful not to add modifier 78 inappropriately as it also reduces reimbursement. If you are not in the global period of a procedure and you apply modifier 78 [...]