Gastroenterology Coding Alert

Tip: For complication with return to OR, look to modifier 78. Can you easily distinguish between modifiers 58, 78, and 79? If not, you'll need to brush up on some modifier basics. Knowing when to apply each can mean the difference between complete reimbursement and costly claim denials. Complications: You'll report modifier 78 (Unplanned return to the operating room for a related procedure during the postoperative period) when conditions arising from the initial surgery (complications) " rather than the patient's condition -- call for a related procedure. Staged procedures: You should append modifier 58 (Staged or related procedure or service by the same physician during the postoperative period) when a procedure or service is planned or anticipated at the time of the original procedure (staged), is more extensive than the original procedure, or represents therapy following a surgical procedure. Tip: You need not return the patient to the operating room to report [...]