Wiki modifier 76 versus 59

[annettebec]

I am having an issue with an HMO insurance company. Example: For Medicare, if we are charging 88305 x 6, we would use modifier 76 on additional 88305's. However, the HMO has all the sudden decided we need modifier 59. Can anyone help me with documentation? I need some documentation that I can send to the HMO insurance company verifying that 76 is the correct modifier. Any help appreciated. Thanks Annette

 

[btadlock1]

I am having an issue with an HMO insurance company. Example: For Medicare, if we are charging 88305 x 6, we would use modifier 76 on additional 88305's. However, the HMO has all the sudden decided we need modifier 59. Can anyone help me with documentation? I need some documentation that I can send to the HMO insurance company verifying that 76 is the correct modifier. Any help appreciated. Thanks Annette

http://www.supercoder.com/articles/...rvice-under-oce-with-proper-use-of-modifiers/

Medicare plays by their own rules...the 59 is technically correct for different specimens/sites.