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76 and 77 Modifier

  1. #1
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    Glendale Geckoders
    Posts
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    Default 76 and 77 Modifier
    Medical Coding Books
    Question:
    Can modifiers 76 (repeat procedure by same provider on the same date) and 77 (repeat procedure by different provider) be used on the same line. We interpret a lot of radiology reports and sometimes it seems like both of the modifiers should be amended.

    Ex:
    Name of physician DOS CPT CODE Modifier
    Dr Smith 01/29/09 71010 26
    Dr.Smith 01/29/09 71010 26 76
    Dr. Jones 01/29/09 71010 26 77

    Dr. Jones 01/29/09 71010 26 76? or 77?

  2. #2
    Smile Modifier
    Quote Originally Posted by belindaziegman View Post
    Question:
    Can modifiers 76 (repeat procedure by same provider on the same date) and 77 (repeat procedure by different provider) be used on the same line. We interpret a lot of radiology reports and sometimes it seems like both of the modifiers should be amended.

    Ex:
    Name of physician DOS CPT CODE Modifier
    Dr Smith 01/29/09 71010 26
    Dr.Smith 01/29/09 71010 26 76
    Dr. Jones 01/29/09 71010 26 77

    Dr. Jones 01/29/09 71010 26 76? or 77?


    NO, you can't use 76 and 77 on the same line.....
    It is either or.....
    Yolanda T. Haskins CPC, CRC, OHCC, AAPC Fellow
    Past AAPCCA Board of Directors 2014 - 2017


    Alexandria, VA Chapter

    ~ Practice Kindness ~

  3. #3
    Default
    you would actually bill it as:
    Dr. Smith 71010-26
    Dr. Smith 71010-26,-76
    Dr. Jones 71010 -26, -77
    Dr. Jones 71010-26, -77 and attach supporting documentation (to show this isnt a dup charge)

    "Modifier 76 – Repeat Procedure by Same Physician – is used to indicate that a procedure or service was repeated in a separate session on the same day by the same physician. This Modifier may be reported for services ordered by physicians but performed by technicians. The procedure code is listed once, and then listed again with Modifier 76 added (two line items). The number of times that the procedure was repeated is reported on separate lines.

    Example: EKG 93000 (Electrocardiogram) routine EKG with at least 12 leads; with interpretation and report) is performed at 8:00 a.m. An EKG, 93000 is ordered and repeated at 1:00 p.m. The patient’s condition requires another EKG, the physician orders it and the EKG is done at 10:00 p.m. This is billed as 93000, one unit (first line) and 9300076, two units (next line).


    Modifier 77 - Repeat Procedure by Another Physician -- is used for a procedure that had to be repeated by a different physician in a separate session on the same day. The procedure code is listed once and then listed again with Modifier 77 added. The number of times the procedure was repeated is reported on separate lines. Do not use the ‘units’ field to indicate that the procedure was performed more than once on the same day. For each additional time the procedure was performed, the code is repeated with Modifier 77 added. Do not use the ‘units’ field to indicate that the procedure was performed more than once on the same day.
    Example: Procedure 44366, small intestinal endoscopy beyond second portion of duodenum, not including ileum, performed two times in a day. The only difference is that a different physician repeats the procedure. Modifier 77 is used instead of 76.

    Modifiers 76 and 77 If you are not sure who ordered the second procedure, or whether the same physician ordered both procedures, code them based on the physician who performed the procedures. The repeated procedure must be the same procedure."

    i got this from here....looks/scroll down towards the end!

    http://www.westvirginia.com/peia/pag...toryid=5547#21
    Last edited by mad_one80; 03-30-2009 at 11:20 AM.

  4. #4
    Smile
    We use 76 modifier on all repeat CPT codes (additional S&I etc.). Medicare (Noridian & WPS) actually requires the 76 modifier on the 2nd, 3rd etc. CPT codes in order to be processed correctly without hitting the duplicate edit.
    Jill Tom, COC, CPC, CPMA, CPC-I
    East Valley Kachina Coders
    East Valley Mesa, AZ AAPC Local Chapter
    President 2011
    President-Elect 2010
    New Member Development Officer 2009
    jillmtom@yahoo.com

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