Corporate Compliance

Tip: Using modifier -78 and modifier -79

Compliance Monitor, November 2, 2005

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This week's tip is a clarification on modifiers -78 and -79.

Use modifier -78 to indicate that an additional procedure or service was performed during the postoperative period of the initial procedure. This modifier indicates that the second procedure was related to the first procedure and required use of the operating room.

Use modifier -79 to indicate that an additional procedure or service was performed by the same physician during the postoperative period. This modifier indicates that the second procedure was unrelated to the original procedure.

These modifiers are used for subsequent procedures performed-not only on the same day as the procedure-but also any time during the post-operative period. Thank you to astute reader Jack McCauley, reimbursement specialist and interim supervisor of coding & reimbursement for the Duke University Health System for alerting us to the need for a clarification.



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