Friday, November 25, 2011

Proper use of 76 Modifier

Use the 76 modifier when billing for separate office or outpatient E/M visits that occur on the same date of service (only for codes 99211–99215) by the same physician/practitioner.

Each service should be clearly documented.

Use the 76 modifier to indicate a separate encounter occurred on the same date of service when separate services are billed. Do not use the 76 modifier for the initial visit.

Example of Proper Usage 
A patient visits the physician on Wednesday morning for a bladder infection. She is treated and sent home. That same afternoon, the patient returns to the physician’s office with a twisted ankle. Each service should be reported with the appropriate level of E/M service with the 76 modifier added to the second visit for the twisted ankle.

E/M Resources
The Evaluation and Management Services Web page on the TrailBlazer Web site, Services/Evaluation and


  1. shall we use the 76 modifer to J codes (drug codes)

  2. should this modifier be used for xolair, 96372 with 2 injs??


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