Saturday, October 30, 2010

Multiple services performent on same day - what modifier to use?

1) If multiple services are performed on the same side, anatomical modifiers must be filed in addition to modifier 76 on the second line item.

Date of Service Place Procedure Number of Services
2/4/03-2/4/03 11 73580-RT 1
2/4/03-2/4/03 11 73580-RT76 1

2) If multiple services are performed on different sides and anatomical modifiers are descriptive, the use of modifier 76 is optional.

Date of Service Place Procedure Number of Services
2/4/04-2/4/03 11 28820-T8 1
2/4/03-2/4/03 11 28820-TA 1

3) Modifier 76 is defined as “repeat procedures by the same physician”. The Agency requires claims for repeat procedures to be submitted as shown below.

The first line must be submitted with only one unit of service with no modifier and lines two through six with modifier 76 with one unit on each line. Any units greater than six must be submitted to Medicaid for administrative review.

Date of Service Place Procedure Number of Services
2/1/06-2/1/06 22 25260 1
2/1/06-2/1/06 22 25260-76 1

Some services may be billed with multiple units of service, depending on the maximum number of units allowed by Medicaid.

Date of Service Place Procedure Number of Services
3/1/06-3/1/06 11 88305 6

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