Cardiology Coding Alert

Question: A patient had an iliac aneurysm repair on May 16, which put his global period ending Aug. 14. On Aug. 10, he returned to the operating room. Should I use modifier 78 or 79?


Louisiana Subscriber

Answer: Modifiers 78 and 79 are both for use on postoperative procedure claims. Choosing the right one depends on the patient's status and whether the original service required a return to the operating room or somewhere else, like the physician's office.

Modifier 78 basics: If your physician performs a procedure and then the patient returns to the operating room with complications, modifier 78 (Return to the operating room for a related procedure during the postoperative period) is your choice. The follow-up procedure must be serious enough that your physician performed it in the operating room -- or you can't use modifier 78.

Apply 79 when new circumstances arise: You should use modifier 79 (Unrelated procedure or service by the same physician during the postoperative period) when:

• your physician must undertake the subsequent surgery for conditions unrelated to an initial surgery, and

• the subsequent surgery occurs during the global period of the patient's initial surgery.

In other words, if the same physician performs a separate evaluation and a distinct, unrelated surgery for a separate condition during the global period of a previous procedure, you should append modifier 79 to the subsequent surgical procedural code(s).

Remember: When you file a claim with modifier 79, a new surgical global period begins.