What is the 78 modifier used for?
an unplanned return to the operating room
Definitions. Current Procedural Terminology(CPT®) modifier 78 is used to describe an unplanned return to the operating room or procedure room during the global period of the initial procedure by the same physician.
How does modifier 78 affect reimbursement?
Modifiers 78: To indicate that a complication of an original procedure was treated by a return to the operating room, catheterization or endoscopy suite. Reimbursement should be at 70-80% of the allowable fee.
What is the difference between modifier 78 and 58?
Modifier 58 and modifier 78 are often mixed up, because both refer to related procedures by the same physician in the post-operative period. However, modifier 58 generally describes staged/planned procedures, while modifier 78 is used for unexpected procedures.
Does modifier 78 restart the global period?
Modifier –78 reimburses the surgeon approximately 80 percent of the allowed amount, depending on the payer, but it does not restart the global period. The global period continues to run from the first procedure.
Can modifier as and 78 be billed together?
CPT modifiers 50 and 78 cannot be submitted for the same service. Instead, submit the surgery procedure code with CPT modifier 78 and HCPCS modifier RT on one detail line, and submit the same surgery procedure code with CPT modifier 78 and HCPCS modifier LT on a separate detail line.
What are modifiers 78 and 79 in hospital ASC?
Medicare’s instructions for modifiers 78 and 79 in hospital ASC or hospital outpatient facilities include in the definition procedures requiring a “return to the operating room on the same day.”
What is the HCPCS code a4649?
HCPCS Code. A4649. The Healthcare Common Prodecure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs.
Does a new postoperative period begin when using modifier 78?
A new postoperative period does not begin when using modifier 78. Medicare allows codes with global surgery indicators of XXX and ZZZ in the Medicare Physician Fee Schedule Database separately without modifier 78.
What is the difference between modifier 78 and 090 global periods?
It does not include a patient’s room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient’s condition was so critical there would be insufficient time for transportation to the OR). Modifier 78 allows for the intraoperative percentage only of major or minor procedures (010 or 090 global periods).