tci Part B Insider - 2004 Issue 40

Part B Coding Coach: Suffering From Repeated Denials On Your Repeat Procedures Claims? Here's Help

Fine-tune your use of modifier -76 and -77 with these expert tips and examplesDon't be fooled: Repeat procedure modifiers may seem self-explanatory, but you could be overlooking some key requirements for payment. Physicians choose to repeat procedures on patients for various reasons. When this happens, appending modifier -76 (Repeat procedure by same physician) or modifier -77 (Repeat procedure by another physician) is essential to tell the carrier your "billing is not a duplicate claim of the originally performed service, but rather an additional claim for payment of the repeated procedure," says Maggie Mac, CMM, CPC, CMSCS, consulting manager...

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