78 vs. 79

[SienTC1720]

A woman has a laparoscopic tubal and then develops a hernia a few days later in her port site. If I am billing for the hernia repair, which modifier do I use?

78 makes sense because the original surgery caused this issue

79 makes sense because its a different body area, technically.

I'm confused here, help me out all you super coders!!

 

[hamlinr2005]

78 is the correct one to use. I am quoting this from a physicianpractice.com article.

Modifer 78 is "The reason for the subsequent surgery is related to the original surgery, meaning that there is a complication of the surgery requiring a return to the O.R. or endoscopy suite"

Modifier 79 is "It is used in the strictest sense for care that is entirely unrelated to the prior surgery that created the current global period." and it proceeds to give an example of a patient in post op for an arthroscopic shoulder falls and fractures their leg and has to go into the OR. The leg has nothing to do with the shoulder.

In your case, the tubal surgery port site caused the hernia. So 78 is the right modifier.