Ophthalmology and Optometry Coding Alert

Question: A patient with a detached retina has another detachment during the same global period. How should I code for the re-repair procedure?

Massachusetts Subscriber

Answer: How you code for re-repair of a detached retina procedure codes 67107-67112 in the global period of the original repair will depend on the modifier definition the re-repair most closely reflects.

If the re-repair is related to or a complication of the original procedure, you need to append modifier -78 (Return to the operating room for a related procedure during the postoperative period) to the appropriate procedure code, unless the re-repair is a greater procedure, then you need to append modifier -58 (Staged or related procedure or service by the same physician during the postoperative period).

The physician may need to indicate that the performance of a procedure or service during the postoperative period was (a) planned prospectively to or at the time of the original procedure; (b) more extensive than the original procedure; or (c) for therapy following a diagnostic surgical procedure when using modifier -58.