Anesthesia Coding Alert

Answer: Both modifier 76 (Repeat procedure or service by same physician or other qualified health care professional) and modifier 78 (Unplanned return to the operating/procedure room by the same physician … following initial procedure for a related procedure during the postoperative period) are more appropriate for the surgeon.

Anesthesia has several options, based on the circumstances and whether it is the same anesthesia provider. Modifier XU (Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service) indicates the service was an unusual service that doesn’t overlap with the usual component of the main (anesthesia) service. Modifier XP (Separate practitioner, a service that is distinct because it was performed by a different practitioner) indicates the service was distinct because a different provider performed it. Either of these modifiers offers a better explanation than modifier 59 (Distinct procedural service), which was once the go-to for same-day take-back services by an anesthesia provider. However, if the insurance company doesn’t accept the X{EPSU} modifiers, it is acceptable to report modifier 59 to denote a distinct procedural service.