Drainage of a Postoperative Seroma

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September 4, 2014

Question:  

We had a patient come into the office for their postop check after a thyroidectomy and neck dissection. The doctor ended up having to drain a seroma. I sent the claim into Medicare with a 78 modifier, but it was denied as included. Did I use the wrong modifier?

Answer:

Payment for complications in the global period will depend on the payer and where the procedure or service is performed. Medicare does not allow separate payment for treatment of complications during the global period unless there is a return to the operating/procedure room (procedure room being in the hospital, such as an angiography suite or endoscopy suite). Because the seroma is a complication of the original procedure and it was drained in the office setting, it is included and isn’t separately payable by Medicare.