When is modifier -76 applied?

Study for the Current Procedural Terminology (CPT) Modifiers Test. Work through flashcards and multiple-choice questions with hints and explanations for each. Ace your exam with confidence!

Modifier -76 is applied when a physician performs a repeated service on the same day by the same physician. This modifier is specifically used to indicate that a procedure or service has been performed more than once, highlighting that it is a different instance of the same service, rather than an error or duplication of a claim.

For example, if a patient requires two separate procedures of the same type during one visit, modifier -76 should be appended to the second procedure to clarify that it was necessary and distinct, even though it was performed by the same provider on the same day. This differentiation is important for accurate billing and reimbursement, as it ensures that the insurance payer understands the circumstances surrounding the repeated service.

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