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Old 07-06-2011, 01:59 PM
NESmith NESmith is offline
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Default Modifier 76 and CPT code 64450

Is it appropriate to use modifier 76 on CPT code 64450? My provider is doing a diagnostic bilateral L5, S1, S2, & S3 dorsal primary ramus injection under fluoroscooic visualization. Claim was billed 64450-507659
Medicare is denying the second and third line as duplicates. Please help.
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Old 07-06-2011, 03:11 PM
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mitchellde mitchellde is offline
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these are not repeated services and you would not use the 76 they are however separate sites which is the 59, which you would use on the second procedure and not the first. A repeated procedure must be the exact same procedure (same site same med same procedure) repeated in a separate session, not the same procedure repeated at different sites or different levels. But a procedure note would help determine if the code is correct in addition to the modifier.

Debra A. Mitchell, MSPH, CPC-H
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