United Healthcare doesn’t like modifier 76 for a repeat surgical procedure when billed in a postop period of a previous unrelated service which also requires modifier 79

For example…

UHC has no problems billing this…

11401
11401 -76 (repeat excision)

No problem billing this…

11401 -79 (excision billed in a 10 or 90 day postop period of a previously unrelated procedure)

UHC doesn’t like this.

11401 -79
11401 -76 -79 (they don’t like 76 and 79 on the same line)

The second is excision is a repeat procedure and is also in a postop period for a previous unrelated service. Both modifiers are appropriate. They will pay the first, but not the second.

What’s the best way around this? Modifier 59 isn’t appropriate as they aren’t bundled procedures according to the NCCI edits.

There are other carriers that don’t like 76 and 79 together, but UHC is a biggie.

What say ye?