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Thread: Modifier 77 ?

  1. #1

    Post Modifier 77 ?

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    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 -
    http://www.cms.gov/manuals/downloads/clm104c12.pdf *pg 87-95

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