# What Modifier - HELP



## cvand1972 (Jul 7, 2009)

Patient has a Loop Recorder implanted on 6/12/09. Returns to the Operating room on 6/15/09 and has it removed and then has a pacemaker implanted. CPT codes are 
33282 6/12/09 
33284 6/15/09 
33207 6/15/09 
Our local medicare (NGS) is denying the 33284 and 33207 stating that the payment is included in another procedure. 
I'm looking at a modifier of 78 but I'm not sure. 
Has anyone else run across something like this?? Or does anyone have any ideas on a modifier??


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## skirache (Jul 7, 2009)

i think modifier 78 best described ur problem.


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## heatheralayna (Jul 7, 2009)

cvand1972 said:


> Patient has a Loop Recorder implanted on 6/12/09. Returns to the Operating room on 6/15/09 and has it removed and then has a pacemaker implanted. CPT codes are
> 33282 6/12/09
> 33284 6/15/09
> 33207 6/15/09
> ...



If the 33282 has a global period, which I do not know off hand if it does, then yes a -78 would need to be used on each of the procedure codes.  -78 is a return to the OR during a global by the same Dr.


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