you would not use the 76 modifier as that is for a reapeated service not a procedure performed a second time in the same session at a separate area of the body. I know that some do advocate the use of units however I have observed in side by side comparison a much higher reimbursement using separate line items with the 59. If you have obnly one add on code then you need no modifier. I also agree that by definition you really do not need any modifier with multiple add on codes , however most payer will deny duplicate line items without the 59. Just my 2 cents here.
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