Radiology Coding Alert

Master Mod 76, Mod 77 by Setting

Keep in mind that this article is aimed at physician coders. For Outpatient Prospective Payment System (OPPS) billing:

If there is a question regarding who the ordering physician was and whether or not the same physician ordered the second procedure, the code selected is based on whether or not the physician performing the procedure is the same.

The procedure must be the same procedure. It is listed once and then listed again with the appropriate modifier.

Resource: You can find this discussed in Medicare Claims Processing Manual, chapter 4, section 20.6.5.CMS allows you to search manuals online at www.cms.hhs.gov/manuals/.)

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