What Is Modifier 76?
Modifier 76 indicates that a procedure or service was repeated by the same physician or qualified health care professional subsequent to the original procedure or service on the same day.
Modifier 76
Also known as: Repeat Procedure or Service by Same Physician
Modifier 76 indicates that a procedure or service was repeated by the same physician or qualified health care professional subsequent to the original procedure or service on the same day.
Definition
Per AMA CPT, Modifier 76 is appended when the same provider repeats the same procedure on the same date — for example, a repeat chest X-ray to evaluate progress or a repeat ECG to capture a recurrent rhythm. Modifier 76 differentiates the repeat service from a duplicate billing error and bypasses the payer's automated duplicate-claim edits. Documentation must support medical necessity for the repeat.
Example
A cardiology patient receives an ECG (CPT 93000) at 9:00 AM and a repeat ECG at 2:00 PM the same day to capture a recurrent arrhythmia. The first ECG is billed standard; the repeat is billed with Modifier 76 appended to identify the medically necessary repeat.
Common Misconceptions
Modifier 76 is not for the same service performed at a different anatomic site (use Modifier 59 or XS) and not for repeats by a different provider (use Modifier 77). It applies only to genuine repeats by the same provider.
Practical Application
Documentation must justify the medical necessity of the repeat — e.g., 'repeat ECG to evaluate recurrent arrhythmia' or 'repeat chest X-ray to evaluate response to treatment.' Without documentation, payers will deny as duplicate.
Related Terms
Modifier 78
Modifier 78 is appended to a procedure code to indicate an unplanned return to the operating or procedure room by the same physician for a related procedure during the global postoperative period of the original surgery.
Read definition arrow_forwardModifier 59
Modifier 59 is appended to a procedure code to indicate that a service was distinct or independent from other non-E/M services performed on the same day, used to bypass NCCI Procedure-to-Procedure (PTP) edits when documentation supports a separately identifiable service.
Read definition arrow_forwardCPT (Current Procedural Terminology)
CPT is the five-digit procedural code set developed and maintained by the American Medical Association that describes medical, surgical, and diagnostic services performed by physicians and qualified health professionals; it is HIPAA-named for use in claims.
Read definition arrow_forwardWhere This Applies on MedPrecision
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