Modifier 76

[KaylaRieken]

I have a patient that is getting a repeat hydroceletomy (55040) during the post op period because it recurred. Would I code this as 55040.76 or do I need a 58 or 78 too? 55040.58/76? 55040.78/76?

 

[twizzle]

Modifier 76 is not appropriate in this case. It represents a repeat procedure/test by the same provider on the same day as another identical procedure, not something done at a later date; think chest x-ray in the morning and another one in the afternoon.

Modifier 58 is not appropriate either. That refers to a planned/staged procedure. Think pacemaker placement and then a week later an a fib ablation. Provider needs to document on the initial procedure that they PLAN to do the ablation at a later date (which will be within the 90 day global).

Modifier 78 would be the correct modifier in this case because the return to the OR is related to the initial procedure.