Reader Questions:
Append -78 for Return to OR
Published on Sun Sep 12, 2004
Question: Our surgeon performed a right total hip arthroplasty. Postoperative films taken later that day showed the femoral component perforating through the canal posteriorly. We immediately brought the patient back to the OR and performed a revision of the right femoral component. Can we bill for both procedures?
Florida Subscriber Answer: Yes. If you return the patient to the operating room, you should report the appropriate total hip revision code (27134-27138) appended with modifier -78 (Return to the operating room for a related procedure during the postoperative period).
To warrant the "return to the OR" modifier, the surgeon must perform the second surgery in a surgical, laser or endoscopic suite - not in the patient's room, a minor treatment room, recovery room or intensive care unit. You should always append modifier -78 to the code for the second surgery, and not to the original
procedure code.
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