AAPC - Back to school
Results 1 to 3 of 3

Thread: Understanding Modifier 78

  1. #1

    Exclamation Understanding Modifier 78

    AAPC: Back to School
    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.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2
    Join Date
    Apr 2007

    Default 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

  3. #3


    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.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

Similar Threads

  1. MFM understanding
    By 1diva in forum OB/GYN
    Replies: 2
    Last Post: 04-30-2015, 04:22 AM
  2. Understanding Modifier 78
    By dballard2004 in forum Family Practice
    Replies: 0
    Last Post: 02-18-2011, 02:39 PM
  3. Need help on understanding E/M coding....HELP!!!
    By kellycz1 in forum Employment General Discussion
    Replies: 0
    Last Post: 01-29-2010, 08:49 AM
  4. Help in understanding Dx coding
    By 007CPC in forum Diagnosis Coding
    Replies: 8
    Last Post: 06-18-2009, 03:35 PM
  5. Understanding CAHABA
    By erikau in forum General Surgery
    Replies: 0
    Last Post: 09-17-2008, 02:27 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.