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Modifier -77

  1. Question Modifier -77
    Medical Coding Books
    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. Default
    Modifier 77 is for procedures performed on the same day. It would not apply to procedures performed on a different day. I like the explanation quoted here:
    General Guidelines

    A. Modifier –77 is used for a procedure that was performed that had to be repeated by a different physician in a different session on the same day.

    B. The procedure code is listed once and then listed again with the modifier –77 added to any subsequent procedure(s). Each time the procedure was repeated should be reported on separate lines.

    C. Do not use the units field to indicate that the procedure was performed more than once on the same day.

    D. If you are not sure who ordered the second procedure, or whether the same physician ordered the both procedures, code based on the physician who performed the procedure(s).

    E. The repeated procedure MUST be the same procedure

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