Ask Dr. Z

I received this memo from CAHABA regarding new changes to -59 modifier effective July 1, 2013

CHANGES WITH MODIFIER -59, Effective July 1, 2013, Modifier -59 can only be used, when medically necessary, to unbundle a procedure code that has been bundled related to the National Correct Coding Initiative (NCCI). Claims billed with the same procedure code two or more times for the same date of service should be submitted with the appropriate repeat procedure modifier rather than using modifier -59.

Multiple Procedure Modifiers -76 and -91, Modifier -76 is used to report a service or procedure that was repeated by the same practitioner subsequent to the original service or procedure. Modifier -91 is used to report repeat laboratory tests or studies performed on the same day on the same patient. Modifiers -76 and -91 do not replace modifiers such as -RT, -LT, -50, -E1-E4, -FA, -F1-F9, -TA, and -T1-T9. If billing a procedure code two or more times for the same date of service, the claim should be submitted with the procedure code listed on one line without the -76/-91 modifier and each subsequent procedure listed on a separate line with the -76/-91 modifier.

My question is... does this apply to same procedure codes done on different vessels in the same setting (which is so common in IR)? For example, a superior mesenteric artery was selected and imaged, and at the same setting the inferior mesenteric artery was selected and imaged, resulting in two procedure codes of 75726. Would I append a -59 or a -76 modifier now?