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Thread: modifer 78 or 76

  1. #1
    Join Date
    Apr 2007

    Default modifer 78 or 76

    AAPC: Back to School
    doc did this procedure about a month ago,do I use 78 OR 76 for the re -excision



    PROCEDURES PERFORMED: Left breast re-excision/left breast lumpectomy.

    PROCEDURE IN DETAIL: The patient was taken to the operating room and placed under MAC anesthesia. The patient was then prepped and draped in a sterile fashion. Time-out was then taken to verify correct patient, operation, and location. After this was done, the incision site was infiltrated with 0.25% Marcaine and a #15 blade was used to re-excise where the previous incision had been. This was by followed electrocautery for dissection into the previous cavity. The inferior portion, which had residual tumor was then located and excised with harmonic scalpel. After this was performed, hemostasis was achieved using electrocautery. After hemostasis was achieved, 3-0 Vicryl was used to approximate deep layer of tissue and the skin was closed with 4-0 Monocry. At the completion of the procedure, Steri-Strips were placed and bandage was put on over the site. The patient tolerated the procedure well. Complications none. Blood loss none. At the end of the procedure, the counts were correct and the patient was taken to recovery. Dr. Minnard was scrubbed and present for the entirety of the procedure.

  2. #2
    Join Date
    Apr 2007
    Northeast Kansas AAPC


    If it was done because margins were too close the first time I would put a 58 on it. The 76 is for the same date of service.

  3. #3
    Join Date
    Apr 2007
    Springfield Mo AAPC


    58, I agree

  4. #4
    Join Date
    Apr 2007


    see page 62 of CPT/guideline. It pertains to the skin excisions but this is still under the integumentary system. Also mod Appendix A, description of 58 sounds better then 78 or 76for this senario.


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