Modifier 78 is used to indicate that the physician who performed a surgery which had a 10 or 90 day global period took the patient back to the OR for a related problem, typically, a complication.  Do not use it for staged or related procedures--that is reported using modifier 58.  For unrelated procedures, see modifier 79.

For modifier 78:

• Appended to the procedure when the return trip is related to first procedure
• If complication does not require a trip to OR, do not use modifier 78.  CMS defines an operating room as a hospital, cardiac cath suite, ASC, laser suite and/or endoscopy suite
• Do not use modifier 78 if the CPT® definition says, "subsequent, related or redo.
• Same physician

Surgical services are defined in the Medicare Fee Schedule as having a pre-operative, intraoperative and postoperative components.  Payment is made only for the intraoperative service when modifier 78 is used.

This is the modifier to use when complications from a surgery require a return trip to the OR, but the same procedure is not repeated.