To use these modifiers, the repeated procedure must be exactly the same as the first and be performed on the same day.

If you are not sure who ordered the second procedure, or whether the same physician ordered both procedures, code them based on the physician who performed the procedures.

Modifier 76: Repeat procedure by same physician

This modifier indicates that a procedure or service was repeated in a separate session on the same day by the same physician.

• Modifier may be reported for services ordered by physicians but performed by technicians.
• The procedure code is listed once, and then listed again with Modifier 76 added (two line items).
• The number of times that the procedure was repeated is reported on separate lines.

Example of modifier 76 use

A physician orders an EKG 93000 (routine EKG with at least 12 leads; with interpretation and report). It is performed at 8:00 a.m. It is repeated at 1:00 p.m. Later, the patient's condition requires a third EKG 93000, the same physician orders it and it is repeated at 10:00 p.m.

This is billed as 93000, one unit (first line) and 9300076, two units (next line).

Modifier 77 - Repeat procedure by another physician

Modifier 77 indicates that a procedure had to be repeated by a different physician in a separate session on the same day.

• The procedure code is listed once, and then listed again with Modifier 77 added (two line items).
• The number of times that the procedure was repeated is reported on separate lines.

Example of modifier 77 use

Procedure 44366 (small intestinal endoscopy beyond second portion of duodenum, not including ileum) is performed on a patient twice in a day. The only difference is that the second procedure is ordered by a different physician.

This is billed as 44366, one unit (first line) and 4436677, one unit (next line).