Wiki Modifier 76 clarification

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Aotearoa16

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I'm getting caught up in the terminology of 'repeat procedure' for the definition of modifier 76. My understanding is that that very literally means a repeated procedure, as in same site/same procedure.

For example 20605 performed in the LT naviculocuneiform joint, the LT talonavicular joint, and the RT talonavicular joint, billed on separate lines, would not need the 76 modifier as these are three separate sites, so these were not repeated procedures. Only a 51 and/or XS modifier would be needed. Is this correct, or would 76 also be appropriate? Is there any clarifying documentation or sources that I can refer to for this issue? Thank you in advance!
 
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It would have to be identical or exact same. Your example is not because they are in different joints. If you were doing RT & LT talonavicular you would want to do one line, one unit, 50 modifier (for most payers unless told otherwise).

You wouldn't use a 51 modifier for the same CPT because they all have the same RVU. If Medicare, Medicare doesn't want the 51 modifier at all. https://www.novitas-solutions.com/w...df.ctrl-state=86hvagjfk_33&contentId=00144532 (Note: Medicare doesn’t recommend reporting Modifier 51 on your claim; our processing system will append the modifier to the correct procedure code as appropriate.)
 
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I am currently in the Billing course but do billing for a podiatrist. We just switched to a new EMR software which does the posting for us. For this particular patient the system is automatically posting codes 11305 then 11305/76 (we treated skin lesions on the RT & LT feet). Normally I would have manually posted this as 11305 then 11305/59 (and have been paid this way by Aetna in the past).
My question - Is the EMR system coding the correct way?
Thank you in advance for your advice.
 
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