Billing and Coding: Repeat or Duplicate Services on the Same Day

Same-day repeated or duplicate services are allowable when properly distinguished on the claim using repeat modifiers (-76 for same physician, -77 for another physician, -91 for repeated lab tests) or appropriate site modifiers (RT, LT, T1, etc.) and/or Days/Units fields on a single claim. Submissions lacking appropriate modifiers, submitted on multiple claims or claim lines for the same date of service, or using modifier -91 in excluded circumstances may be denied; claims denied as not medically necessary require appeal with supporting documentation. Wait up to 30 days before resubmitting a claim and use Palmetto GBA IVR/OPS for status inquiries; minor corrections should be handled via claim reopen rather than filing a new claim.

"A repeated identical procedure performed later the same day by the same physician is covered when the original service is submitted without modifier -76 and the repeat service is submitted with CPT..."