Medical Billing Forum
Coding => Coding => : chandru_2k15 June 30, 2015, 11:40:56 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.
-
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
-
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.
-
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.