76 - JE Part B
Repeat procedure or service by same physician or other qualified health care professional
Used to indicate a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service.
- Procedure or service is performed on the same day
- Append 76 modifier to the repeated procedure or service CPT code only
- Used for surgeries, x-rays and injections
- Not appropriate with laboratory or pathology codes (append modifier 91)
- Not appropriate to use with equipment failure
- Should not be appended to an E/M service
- Does not replace modifiers such as RT, LT, 50, E1-E4, FA, F1-F9, TA, and T1-T9
Claim Example - Two Chest X-Rays
Correct Claim Example - Three Chest X-Rays
Incorrect Claim Example – Three Chest X-Rays
In this example, line three will deny as an exact duplicate of line two.
- CMS Internet Only Manual (IOM) Medicare Claims Processing Manual, Publication 100-04, Chapter 12, Section 30.6
Last Updated Fri, 24 Sep 2021 17:46:24 +0000