Wiki 76942, with 76 modifier?? - considered identical

[deansmommy4]

Is it appropriate to bill a 76 modifier if you are doing a 76942 bilaterally?

For example, 76942-RT, 76942-76LT

I personally don't think so
a 76 is for a repeat procedure, which means to me "identical".

It is not considered identical because it is being done on a different body part.
Correct??

Thank you.

 

[amicotaylor]

I would not use the modifier 76 unless you are doing two of the same side.
For example 76942-RT & 76942-76RT

 

[ollielooya]

I struggled with this too for one of our providers and sometimes it is dependent on carrier guidelines. We do use the LT and RT modifiers and again, depending on carrier you may only have one side or unit paid due to the NCCI guidelines. What makes it so confusing, is that sometimes they will pay for both and sometimes not. As far as MCR is concerned, I wish the modifier GD would be accepted by the contractors, as the MUE's could be overwritten provided the documentation was accurate. Our provider also uses modifier 76 as indicated by your question.