Two surgeons perform a specific procedure – Modifier 62

Modifier 62 Fact Sheet Definition: • Two surgeons (each in a different specialty) are required to perform a specific procedure Appropriate Use: • If two surgeons (each in a different specialty) are required to perform a specific procedure, each surgeon bills for the...

Distinct Procedural Service – Medicare modifier 59

Modifier 59 Fact Sheet Definition: • Distinct Procedural Service identifies procedures/services not normally reported together, but appropriately billable under the circumstances. Appropriate Usage: • Documentation indicates two separate procedures performed on the...
Medicare modifier 58 and appropriate usage

Medicare modifier 58 and appropriate usage

Modifier 58 Staged or Related Procedure or Service by the Same Physician During the Postoperative Period Definition: • Indicates a staged or related procedure or service by the same physician during the postoperative period Modifier “-58” (Staged or related...

Medicare modifier 57 – when to use

Modifier 57 Fact Sheet Definition: • Indicates an Evaluation and Management (E/M) service resulted in the initial decision to perform surgery either the day before a major surgery (90-day global) or the day of a major surgery. Appropriate Usage: • Append where the...

Usage of Medicare modifier 55

Modifier 55 Fact Sheet Definition: Modifier 55 –  Postoperative Management Only • Indicate a physician, other than the surgeon, is billing for part of the outpatient postoperative care. • Also, used by the surgeon when providing only a portion of the...