Ophthalmology and Optometry Coding Alert
OR-Treated Complication Leads to Modifier 78
Question: A patient returned to the operating room to treat a complication within the global of a detached retina repair. How do I decide whether to use modifier 78 or 79? Is a complication “related”?
Answer: For a return to the operating room to treat a complication, choose modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period). As the descriptor states, using the modifier is appropriate only if the procedure requires a return to the OR or a procedure room for a problem related to the original surgery.
79 for new: Using modifier 79 (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period) would be appropriate when you meet these conditions:
The procedure or service is for a condition unrelated to the initial surgery
The subsequent unrelated surgery occurs during the initial surgery’s global period.
Related Articles
Ophthalmology and Optometry Coding Alert
- Correct Coding Initiative:
New CCI Edits Restrict Visual Screenings With E/Ms
Fortunately, you can use a modifier to separate the edits when warranted. Although most ophthalmology [...] - Revenue Builder:
Follow This Practice Administrator's Lead to Collect More of Your Fees
Hint: Requesting self-pay amounts before surgery makes all the difference. Chasing down copays, deductibles and [...] - ICD-10:
Let 'Z' Codes Support Your Ophthalmology Claims and Help Bring in Payments
These codes aren’t just to make your claims lengthier—they serve an important purpose. When it [...] - These Z Codes Can Make Your Claims Shine
Eye care practices that are unfamiliar with additional Z codes beyond the ones mentioned here [...] - Reader Question:
Modifier 24 Shouldn't Change Dx Choice
Question: Can you use modifier 24 when the surgery and the E/M with 24 have the [...] - Reader Question:
Locum Tenens Physicians Have Time Limits
Question: We are planning to hire a locum tenens (LT) physician for an ophthalmologist that’s going [...] - Reader Question:
OR-Treated Complication Leads to Modifier 78
Question: A patient returned to the operating room to treat a complication within the global of [...] - You Be the Coder:
Look to Documentation for Diagnosis Code
Question: How can I find an acceptable diagnosis code for 76514 (Ophthalmic ultrasound, diagnostic; corneal pachymetry, [...]
