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Modifier 77 ?

  1. Post Modifier 77 ?
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    Here is the scenero, the pt previously underwent an ACDF in Jan 2011 in a different city than which we are located. He recovered from that Sx, but then fell and had similiar symptoms that returned and required a re-do of the Sx at our center. (long story short)

    1. Redo anterior cervical diskectomy C5-6 and C6-7 with decompression of spinal cord and nerve roots.
    2. Anterior cervical arthrodesis with PEEK graft filled with DBM C5-6 and C6-7.
    3. Anterior cervical plating with Abbott Spine Zimmer plating from C5-7.
    4. Removal of prior plate, screws, PEEK graft
    4. Microscopic dissection.
    5. Intraoperative fluoroscopy.

    My question is should I code using the modifier -77 as follows:

    22551 - 77
    22552 - 77
    22851 - 59

    Any input would be GREATLY appreciated!!

  2. #2
    Fort Smith, AR
    Default Modifier 77
    The guidelines for modifier 77 are the same as 76 except another physician. This link shows that at the bottom under * info. So I don't believe it would be appropriate to bill using modifier 77 in this case, as the service wasn't on the same day.

    I would say use modifier 78 if within original global period. Would these conditions apply?

    Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period.

    Global Days CMS Documentation - *pg 87-95

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