Coding with Modifiers: A Guide to Correct Cpt and HCPCS Level II Modifier Usage
American Medical Association, Jan 1, 2004 - Medical - 420 pages
Don't forget about the modifier. Missing or incorrect usage of modifiers is the most common reason that claims are rejected by payors. Leave off a modifier, or put in the wrong one, and your claim may be denied or paid the wrong amount. Coding with Modifiers: A Guide to Correct CPT and HCPCS Level II Modifier Usage provides step-by-step guidance for the proper use of CPT and HCPCS modifiers. Also included are specific requirements for modifier usage in both professional service and hospital reporting.
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add-on code adding the modifier additional and/or anesthesia anesthesia services anesthesiologist append modifier appropriate artery arthrocentesis assistant surgeon bilateral procedures Billed catheter cedure circumstances claim clinical CMS Guidelines code with modifier Code(s colonoscopy CPT book CPT code set CPT modifiers diagnosis code diagnostic direct face-to-face documentation E/M code E/M service emergency department endoscopy established patient evaluation and management examination Examples Example global surgical graft HCPCS codes HCPCS level hospital outpatient indicate insurance carrier laboratory lesion mammography Medicaid medical decision medical necessity Medicare modifier 25 modifier 59 modifier 62 monitoring multiple procedures operating room operative session original procedure payment physical status modifiers physician physician performed postoperative period preoperative primary surgeon procedure code procedure or service procedures performed professional component prolonged services prosthesis radiology Rationale reimbursement related procedure Review of Modifier separate procedure service provided submitted surgeon performed surgical procedure technical component Third-Party Payer Guidelines unrelated