78 - JE Part B
Return to Operating Room for related surgery during post op period
This modifier is appended to another surgical code for an unplanned return trip to the operating room during global post op (10 or 90 days).
Append 78 modifier in first position as the pricing modifier
- E.g., Possible complications
- Payment limited to allotted intra-op services only
- Append modifier 58 if return procedure was staged or planned
- If Medicare Physician Fee Schedule (MPFS) indicator list marked with "XXX", then no modifier needed as the code has no global dates
Claim Coding Example
- Provider performs bypass on February 24, 2015, and then nine days later, because of a possible infectin, an unplanned return trip back to the operating room for a chest wall exploration.
|2/24/15||Coronary artery bypass||33514|
|3/5/15||Explore chest wall||35820 78|
- CMS Internet Only Manual (IOM) Medicare Claims Processing Manual, Publication 100-04, Chapter 12, Sections 30 and 40.2
Last Updated Wed, 12 Feb 2020 16:02:12 +0000