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.
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Be sure and check out this discussion with LaMont Leavitt (CEO of innoviHealth) and Christine Taxin (Adjunct professor at New York University, President of Dental Medical Billing, and Links2Success).
Some of the resources and tools they discuss will help you with your dental coding/billing and education.
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Discussion between innoviHealth CEO, LaMont Leavitt and Guest speaker, Christine Taxin who is an Adjunct professor at New York University, and President of Dental Medical Billing and Links2Success about making sure you have all the right Dental resources needed to succeed in Dental Medical Billing and Coding.
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