Modifier 76 Description
When a process or service is repeated by the same physician or other competent health care professional after the following procedure or service, it is referred to as a repeat process or service. When two physicians in the same group with the same specialty operate repeat offerings on the same day, Medicare considers them the same physician. Then, we must append modifier 76 to the subsequent repeat process within the same day.
Correct application
The process or service is completed on the same day.
Append the modifier 76 to the repetitive process or service.
It is used in surgeries, x-rays, and infusions.
Wrong application
- Adding to each service area.
- Adding a code to a surgical procedure.
- An unexpected return to the operating room.
- Procedure or service that is unconnected (modifier 79).
- Services must be repeated due to equipment or technical fault.
- Refer to Current Procedural Terminology (CPT) modifier 91 to repeat laboratory services.
- Services are replicated for quality assurance reasons.
- A service or process was rendered more than once; unexpected occurrences occurred.
This modifier should not be reported with ‘add-on’ codes signified in CPT by a “+” sign. If the same supplier repeats or provides a service defined as an ‘add-on’ code multiple times (based on description) on the same day, reveal the ‘add-on’ code on one connection with a multiplier in the unit field to imply how many times that service was conducted.
CPT 64636 (billed in addition to the primary code 64635), for example, is noted on one line as 64636, units equal 3 (or the total number of additional facet joints (not bilateral) charged in addition to the initial facet joint charged under CPT code 64635). In this case, if CPT instruction is supplied bilaterally, follow it.
