Practice Management Alert

Question: One of our surgeons performed a hemorrhoidectomy for a patient in 2001. Another surgeon in our practice performed an identical hemorrhoidectomy on the same patient in 2005. I billed the second procedure with modifier 77, and the payer reduced our reimbursement because of the modifier. When is it appropriate to report modifier 77?


Pennsylvania Subscriber
Answer: You should report modifier 77 (Repeat procedure by another physician) when another surgeon repeats a procedure on the same day. The modifier alerts the payer that you have not mistakenly (and inappropriately) reported the procedure twice. The hemorrhoidectomy (e.g., 46255, Hemorrhoidectomy, internal and external, simple) in 2005 isn't really a "repeat" of the same procedure in 2001, as described by modifier 77. Billers rarely use modifier 77 for general surgery services. More typically, a radiologist might use the modifier to indicate two x-rays on the same date of service, for instance.
 
In this case, you should contact the payer and inform it of your error: Your physician deserves full reimbursement for the hemorrhoidectomy.