By recei Modifier:
A modifier helps to report that a service that has been performed has been altered by some specific circumstance but there has not been any changes in its definition or code.
Modifier 76:
Modifier 76 is appended; this modifier if used highlights that the procedure was repeated by the same healthcare provider on the same day subsequent to the original service. it can help in getting payment if the insurance denies the claim for duplication. Coders can append this modifier.
Note: Never append this modifier with an Evaluation and Management services and should be appended with the CPT codes. Although the CPT code book does provide the information of application and use of modifiers it is important to follow the guidelines of the specific payer policies.
Example: A physician named mark ordered an EKG (CPT 93000) and it was performed twice due to the some condition and then the modifier 76 can be attached with the CPT code which was performed later.
The initial procedure would be reported as 93000 (1 unit) and the repeat procedure as 93000-76 (1 unit).
Modifier 77:
Modifier 77 is appended, when repeat procedure or service performed by another physician/other qualified healthcare professional(QHP) on the same day. It means we need to indicate modifier 77, when services are repeated on the same day by another physician/other qualified healthcare professional.
Important Note: Modifier 77 should not be reported with an Evaluation and Management services.
Example: A physician named Mark interpreted Chest x-ray (71045) and it was interpreted again by another physician named John then the modifier 77 can be attached with the CPT code which was interpreted later.
The initial procedure would be reported as 71045-26 and the repeat procedure as 71045-26-77 (1 unit). 26 represent the professional component.
Important Points:
- Modifiers 76 and 77 are reportable only with procedure services.
- Never append it with Evaluation and Management (E/M) service codes.
- Do not report modifiers 76 and 77 on the same procedure line.
- If the insurance payer finds that the modifier is not attached then it will deny the repeated procedure as a duplicate service rather than a separate service.
Conclusion:
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