What does modifier 76 indicate?

Modifier 76 Used to indicate a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service.

When should modifier 76 be used?

Modifier 76 is used to report a repeat procedure or service by the same physician and is appended to the procedure to report: Repeat procedures performed on the same day. Indicate that a procedure or service was repeated subsequent to the original procedure or service.

What is modifier 76 medical billing?

CPT Modifier 76: ‘Repeat procedure by same physician: The physician may need to indicate that a service was repeated the same day subsequent to the original service. This modifier indicates the difference between duplicate services and repeated services.

How many times can you use modifier 76?

As I have told you, Modifier 76 can be used only when the same procedure is performed same day. However, in Medical coding we give same CPT codes even for different procedure. We have limited CPT codes so there are few CPT codes used again if a same kind of procedure is performed but on different anatomic location.

How does modifier 76 affect reimbursement?

If a claim is submitted with Modifier 76 without supporting documentation, the claim will be denied. Providers will be asked to submit the required documentation for reconsideration of reimbursement. Failure to use Modifier 76 when appropriate may result in denial of the procedure or service.

What is the difference between modifier 59 and 76?

Modifier 59 refers to procedures or services completed on the same day that is because of special circumstances and are not normally performed together. Modifier 76 refers specifically to the same procedure performed multiple times by the same medical professional after the initial service.

What is the difference between modifier 76 and 77?

Modifier -76 is used to indicate that the same physician repeated a procedure or service in a separate operative session on the same day. Modifier -77 is used to indicate that another physician repeated a procedure or service in a separate operative session on the same day.

Can modifiers 59 and 76 be used together?

Modifier Combinations If Modifier 76 is included in the medical claim, then it is considered invalid if used with Modifier 59. Modifier 59 refers to procedures or services completed on the same day that is because of special circumstances and are not normally performed together.

Can modifier 76 and 77 be used together?

This circumstance may be reported by adding modifier 77 to the repeated procedure or service. NOTE for Modifiers 76 and 77: The procedure must be the same procedure. It is submitted on the claim form once and then listed again with the appropriate modifier.

When should I use modifier 59?

Modifier 59 should be used to distinguish a different session or patient encounter, or a different procedure or surgery, or a different anatomical site, or a separate injury. It should also be used when an intravenous (IV) protocol calls for two separate IV sites.

What is a modifier 50?

Use modifier 50 to report bilateral procedures performed during the same operative session by the same physician in either separate operative areas (e.g., hands, feet, legs, arms, ears) or in the same operative area (e.g., nose, eyes, breasts).