Question: West Virginia Subscriber Answer: You can separately report the needling of the bleb, 66250 (Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure), using modifier 78 (Unplanned return to the operating/procedure room by the same physician or non-physician provider following initial procedure for a related procedure during the postoperative period) but only if the needling of the bleb was performed in an operating-room setting. Hospital operating rooms, ambulatory surgical centers, and designated laser procedure suites are all considered operating-room settings by Medicare and most Medicare carriers. If, however, the needling procedure was performed in a non-operating-room setting -- for example, in the office or minor procedure room -- the procedure is not separately billable.