Modifier 76- Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional

Modifier 76 is used when the same procedure or service must be repeated by the same physician or qualified healthcare professional.

What is Modifier 76?

Modifier 76 tells insurance payers that a procedure or service was intentionally repeated by the same provider. It helps distinguish a medically necessary repeat service from duplicate billing.

When to Use Modifier 76

• The same procedure or service is repeated
• The same provider performs both services
• The repeat service is medically necessary
• Documentation supports the reason for repeating the procedure

Billing Example

A patient undergoes a diagnostic imaging procedure. Later, the patient's condition changes and the same provider determines that repeating the procedure is medically necessary. Modifier 76 may be appended to the repeated service.

Documentation Tips

• Document why the procedure was repeated
• Record the timing of both services
• Explain any change in the patient's condition
• Maintain results from both procedures

Common Denial Reasons

• Repeat service appears to be a duplicate
• Medical necessity is not supported
• Missing documentation for the repeated service
• Incorrect modifier usage

Related Modifiers

Modifier TC

Modifier 26

Modifier 91

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