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Wiki ASC - modifier 78

KoBee

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We got a denial from Medicare using modifier 78 on a patient who had to return back to surgery due to findings of Cataract (lens) fragments in eye. The diagnosis that was used was H59.021.

Has anyone run into this issue and what was your resolution? I wasn't aware in ASC modifier 78 is not allowed.

It was coded and billed on a both facility/professional claims.

Help :/
 
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