# Modifier 77 ?



## Jasper74 (Mar 9, 2011)

Here is the scenero, the pt previously underwent an ACDF in Jan 2011 in a different city than which we are located. He recovered from that Sx, but then fell and had similiar symptoms that returned and required a re-do of the Sx at our center. (long story short)

PROCEDURES PERFORMED:
1.  Redo anterior cervical diskectomy C5-6 and C6-7 with decompression of spinal cord and nerve roots.
2.  Anterior cervical arthrodesis with PEEK graft filled with DBM C5-6 and C6-7.
3.  Anterior cervical plating with Abbott Spine Zimmer plating from C5-7.
4.  Removal of prior plate, screws, PEEK graft
4.  Microscopic dissection.
5.  Intraoperative fluoroscopy.

My question is should I code using the modifier -77 as follows:

22551 - 77
22552 - 77
22849
22851
22851 - 59
20930

Any input would be GREATLY appreciated!!


----------



## Ldari (Mar 14, 2011)

*Modifier 77*

The guidelines for modifier 77 are the same as 76 except another physician. This link shows that at the bottom under * info. So I don't believe it would be appropriate to bill using modifier 77 in this case, as the service wasn't on the same day. 
http://www.wpsmedicare.com/j5macpartb/resources/modifiers/informationalmodifiers.shtml


I would say use modifier 78 if within original global period. Would these conditions apply?

Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period.

Global Days CMS Documentation - 
http://www.cms.gov/manuals/downloads/clm104c12.pdf *pg 87-95


----------

