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Thread: Modifier 78

  1. #1
    Join Date
    Apr 2007
    St. Louis, Missouri

    Default Modifier 78

    AAPC: Back to School
    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)?

    Melissa Blow, CPC

  2. #2


    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?


  3. #3
    Join Date
    Apr 2007


    I would use the 78 modifier because the modifier description does state "operating/procedure room".

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