Modifier 78

mmelcam

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Now that modifier 78 description has changed to read... Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period, does anyone know if we can use this modifier when a patient comes into the office after a surgery and has a complication (such as a seroma) and we take the patient to our procedure room in our office and perform another procedure (such as i&d of a seroma)?
 

shensley

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I have the same question!
Everything I found on Codecorrect (quoted below) seems to really push the OR as a room only used for procedures:

"100-04 Claims Processing Manual Section 040
Chapter 12-Physician Billing
Subject Physicians/Nonphysicians Practitioners - Section 40 - Surgeons and Global Surgery
Treatment for postoperative complications which requires a return trip to the operating room (OR). An OR for this purpose is defined as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient's room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient's condition was so critical there would be insufficient time for transportation to an OR);"​


Anyone else have insight on this scenario?

Sonya
 
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