Modifier for bring back to O.R same day
Hi,
Agree with wassock to a degree.
Modifiers 77, 78 & 79 are meant for the surgeons who bring the patient back to the OR during the global period.
Anesthesia doesn't really have a global period so these modifiers don't apply.
However, to break out 2nd case from the 1st, we have to tell the insurance companies that it was a different encounter. Without a modifier of some sort, the payers will deny the 2nd set of codes as inclusive to the first - without regard to start/stop times. Essentially, the claim that hits first will be the claim they'll pay on. What a pain - you'd think they'd have some way to look at the time, right?
Two modifiers somewhat apply here: 59 or 76.
Medicare Carriers all over the country are now requiring modifier 76 (repeat procedure) on the 2nd anesthesia case vs. modifier 59 if the CPT/ASA codes are the same. This tells them that it's a repeat anesthesia service at a later part of the day/evening.
Some payers will continue to want modifier 59 - but do remember this is a modifier of last resort.
Not saying I agree with modifier 76, but just be aware of some of the changing situations out there.
Leslie J