tci Part B Insider - 2008 Issue 28

Modifier Quiz: Save Modifier 76 for True Repeat or Risk Overpayment

Modifier 59 might apply even when you use the same codeYou could mislabel a modifier 59 procedure as a modifier 76 one and incorrectly get full payment, if you fail to check that the second procedure occurs on the same anatomy as the first.Modifier 76, per CPT, is a repeat procedure or service by the same physician, says Therese Burke, BS, CPC, a coding instructor and consultant with Medical Office Alternatives in Chepachet, R.I. You use it to let the payers know that the claim is not a duplicate.If the physician didn't perform the same procedure...

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