We had a patient that had colonoscopy with polypectomy/biopsy performed in the am but then returned to the OR that evening for a colonoscopy with bleeding control performed at the site of the polypectomy. Patient never left the facility. My question is for hospital outpatient billing, would modifier -78 be appropriate to use on the colonoscopy CPT for bleeding control (45382) or would modifier -XE be more appropriate? The CPT book doesn't provide great guidance on use of modifier -78 being a physician ONLY billing modifier.