What is the process for coding a repeat procedure?

The process for coding a repeat procedure involves accurately representing the service performed, which is done by assigning the same code for the procedure as initially performed. This includes the potential addition of appropriate modifiers to indicate that it is a repeat procedure. Modifiers provide crucial information about the circumstances of the repeated surgery, such as whether it was performed on the same site, if it was a staged procedure, or if it was a distinct procedural service.

Using modifiers allows coders to communicate nuances of the service provided to insurers and ensure proper reimbursement. For instance, the modifier "-76" indicates a repeat procedure by the same physician on the same day, while modifier "-78" specifies a return to the operating room for related procedures.

Assigning a different code for each occurrence is not accurate, as it does not reflect the specifics of the procedure. A code ending with "99" is not a standard practice for indicating repeat procedures; such codes often represent special circumstances rather than consecutive surgeries. Consulting with the patient's insurer might be a good practice but is not a standard part of the coding process itself.

Therefore, the correct process requires assigning the code for the procedure and utilizing the right modifiers when necessary to reflect that it is a repeat procedure.