If the modifier 78 states it's for "intra operative" reimbursement only, can I use the modifier 54/55 with mod 78? When yag laser is performed on the same eye as previous cataract surgery within the 90 day global period of that cataract surgery we are asked to add modifiers 5478 as the patient returns to their regular optometrist after the ophthalmologist perfoms the yag. We aren't being reimbursed for any pre-op or post op care so how can the optometrist claim part of the "postop" care with a modifier 55 claim? Any one have any thoughts on this?