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Modifier 76 Repeat Procedure or Service by Same Physician

March 25th, 2009 - Codapedia Editor
Categories:   Coding   Modifiers   Surgical Billing & Coding  
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Modifier 76 is used to report the service when the same procedure is performed by the same physician, on the same patient either the same day of the previous procedure or doing the global period.  The modifier tells the payer that this is not a duplicate bill, but that the same procedure was performed twice.  It requires the use of the same procedure code.   The modifier may be used on procedures or diagnostic tests.  

In the operative report, indicate the medical necessity for the repeat procedure.  Most payers will decrease the payment for the repeat procedure.

Remember that Medicare and other payers pay for physicians in a group of the same specialty as if they were one physician. That means, if a physician of the same specialty performs the repeat procedure, bill it with modifier 76.

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