Wiki 59 vs 76

[magmae]

Can some please advise - what is the main difference between the 2 modifiers? I have been told that as of 2014 Medicare is requiring the use of 76 on cpt 43274 (ercp stent) but have not been able to locate anything stating this. Everything I read and the CPT state to use 59 for multiple stents.

My take is that since the stents would be in separate locations/ducts that the 59 applies (as this is an NCCI modifier) and 76 would be for say multiple EKG's on the same pt but at different times on the same day (as this is not and NCCI modifier)

Can anyone please clerify and if you know of where I can get info from Medicare regarding this that would be great. Thank you.

 

[574coding]

We thought the same thing, but we had a webinar with Noridian and they reocmended that we use both 59 and 76 until they get the bugs worked out of their system. This has worked for us. They said to keep an eye out for any change in the newsletter. Hope this help.