Question: How can I report ASC services when the physician returns the patient to the operating suite to deal with complications, such as postoperative bleeding? Is a modifier necessary?
Michigan Subscriber
Answer: Every procedure performed in the ASC has a "same day" global period. This makes sense because the ASC is not reporting physician work services -- only facility fees.
Therefore, for instance, if a patient has postoperative bleeding and the physician must return the patient to the ASC for control of bleeding (or other complication) on the same day, you would report the appropriate code for control of bleeding with modifier 78 (Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period) appended because the procedure occurred within the "same day" global period for the ASC.
But if the physician returned the patient to the ASC the day after the initial surgery (or on any subsequent day), you would report the appropriate code for control of bleeding with no modifier attached. For the purpose of the ASC, the initial surgery’s global period has expired, even though the surgery includes a 90-day global period for physician services.
