Gastroenterology Coding Alert

Hint: The physician must return the patient to the operating room.
Need to know when to apply modifier 78 instead of similar modifiers such as 58 and 79? Just ask yourself these three questions. If all the answers come up “yes,” you can safely assume that 78 is your modifier of choice. 1. Does the Procedure Fall Within a Global? You only apply modifier 78 (Unplanned return to the operating/procedure room by the same physician following  initial procedure for a related procedure during the postoperative eriod) if a subsequent procedure by the same surgeon falls within the global period of an earlier surgery. Example: Your gastroenterologist places a gastrostomy tube -- 49440 (Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection[s], image documentation and report) -- but eight days later, the tube leaks and the physician returns the patient to the operating room to change the tube. [...]