General Surgery Coding Alert

Question: One of our surgeons performed a hemorrhoidectomy for a patient in 2001. Another surgeon in our practice performed an identical hemorrhoidectomy on the same patient in 2005. I billed the second procedure with modifier -77, and the payer reduced our reimbursement because of the modifier.

My question is: When is it appropriate to report modifier -77 (Repeat procedure by another physician)?


Pennsylvania Subscriber


Answer: You should report modifier -77 (Repeat procedure by another physician) when another surgeon repeats a procedure on the same day. The modifier alerts the payer that you have not mistakenly (and inappropriately) reported the procedure twice.

The hemorrhoidectomy (e.g., 46255, Hemorrhoidectomy, internal and external, simple) in 2005 isn't really a "repeat" of the same procedure in 2001, as described by modifier -77.

You would rarely access modifier -77 in a general surgery practice. More typically, a radiologist might use the modifier to indicate two x-rays on the same date of service, for instance.
 
In this case, you should contact the payer and inform it of your error: Your surgeon deserves full reimbursement for the hemorrhoidectomy.