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DecisionHealth, DecisionHealth - 2017 Issue 6 (June)

Modifier 78: Little used, and much denied — for some codes in particular

Modifier 78 (Unplanned return to the operating/procedure room by the same physician) is a tough one to get accepted by Medicare contractors. In fact, an analysis of the most recent Medicare data available shows the aggregate denial rate for codes with 78 was 83%. But some codes do much better with it than others.

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