Wiki Understanding Modifier 78

[dballard2004]

The CPT definition of modifier 78 states, "Unplanned return to the operating/procedure room by the same physician following inital procedure for a related procedure during the postoperative period."

CMS gives a great definition of an operating room, but how exactly do you define a procedure room? Would this modifier be applicable to a physician's office? Let's say the patient had surgery done in a physician's office, but it was done in an exam room and not a procedure room, and then we had to do a related procedure again in the exam room. Would this be modifier 78? What exactly defines a procedure room?

I hope my question is clear here.

Thanks in advance.

 

[lmz0330]

Procedure Room

This is really infuriating, but I was told that it can not be an exam room, or an intensive care room. It is a room used only for "procedures" like a cath lab. Hope this helps you.

Lori cpc,ccvtc

 

[dballard2004]

This is very frustrating. I am not sure that this modifier would even apply in the physician office setting. Thanks so much for the help.