January 2007 page 28d
Coding Communication:Surgery: Eye and Ocular Adnexa
Question
For diagnostic purposes, the physician
closed the patient's lacrimal puncta with a
collagen plug for dry-eye syndrome. A week
later, the lacrimal puncta was therapeutically
closed with a silicone plug. Is it appropriate to
append modifier 76, Repeat procedure by same
physician, to the second procedure code (ie,
68761) to indicate that this is a repeat procedure
by the same physician?
AMA Comment
No. Modifier 76 is not appended
because the two services, although both are
reported with code 68761, Closure of the lacrimal
punctum; by plug, each...
Note: The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.
Article Overview
This article is a brief CPT Assistant coding communication for eye and ocular adnexa services. It addresses a question about reporting a lacrimal puncta closure service when similar procedures are performed close together for different clinical reasons, and it highlights the general modifier-related guidance discussed by AMA. It is most relevant to coders and billing staff working with ophthalmology-related procedures and CPT reporting policy.
Why This Topic Matters
It helps readers understand how the article frames repeat-procedure modifier use in an ophthalmology setting and why the distinction between similar services matters for CPT reporting.
Article Sections
Coding Communication: Surgery: Eye and Ocular Adnexa
Introduces a coding question involving an ophthalmic procedure and a modifier-related reporting issue. The section presents the AMA's response in the context of CPT Assistant guidance.
What You Will Learn
The article’s focus within CPT Assistant coding communication for eye and ocular adnexa services.
How the discussion addresses modifier-related questions for similar procedures performed in a short timeframe.
The general context in which ophthalmology coders seek guidance on reporting questions.
The type of AMA commentary provided in response to a coding question.
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