Medical Billing Forum

Coding => Coding => Topic started by: chandru_2k15 on June 30, 2015, 08:40:56 AM

Title: Repeat radiology procedure
Post by: chandru_2k15 on June 30, 2015, 08:40:56 AM
Hi,

Can someone tell me if modifier-76 can be appended on CPT 76816 to indicate a repeat procedure performed by a same physician?

Any help is greatly appreciated!!

Thanks,
Chandru J.
Title: Re: Repeat radiology procedure
Post by: cpsllc on July 01, 2015, 02:48:30 PM
If a procedure is performed for a second time in the same day you can bill with modifier 76, to
identify the repeated procedure by the same physician; or with modifier 77, to identify that the procedure was repeated by another physician
Title: Re: Repeat radiology procedure
Post by: RichardP on July 01, 2015, 03:15:44 PM
CPT Code 76816 is for doing an ultrasound on a lady pregnant with twins.

https://www.google.com/?gws_rd=ssl#q=CPT+76816

Several of the state programs shown in that link state specifically that the ultrasound procedure should be charged twice, because it is performed twice - once for each fetus.  But that doesn't mean that a given insurance carrier will have the same standard.  The best bet would be to contact your target insurance carrier(s) and ask them specifically what their standard is.
Title: Re: Repeat radiology procedure
Post by: chandru_2k15 on July 02, 2015, 09:43:51 AM
Thank you Richard & Cpsllc!

I tried billing with a 76 modifier to indicate the procedure was performed twice by a same physician but for some reasons the claims are being rejected by the clearinghouse citing inappropriate modifier being used and my office manager tells me to append with 59 Modifier. I kind of skeptical to use 59. Anyways as Richard suggested I'd call the insurance in question.

Your response is greatly appreciated!!

Thank you,
Chandru J.