by Medical Billing | Jul 22, 2016 | CPT modifiers
Procedure code and description 99211 – Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s)...
by Medical Billing | Jul 22, 2016 | CPT modifiers
CPT code 99211 should not be used to bill Medicare: • For phone calls to patients. • Solely for the writing of prescriptions (new or refill) when no other E/M is necessary or performed. • For blood pressure...
by Medical Billing | Jul 22, 2016 | CPT modifiers
Modifiers to be used for Part A Program Category Modifier Code Description PART – A E/M 25 Significant, separately identifiable Evaluation and Management (E/M) service by the same physician on the same day of the procedure or other service. PART – A Method...
by Medical Billing | Jul 22, 2016 | CPT modifiers
Modifiers to be used for Part B Program Category Modifier Code Description PART – B Physician Quality Reporting 1P Physician Quality Reporting System – Performance measure exclusion modifier due to medical reasons. PART – B Surgical 22...
by Medical Billing | Jul 22, 2016 | CPT modifiers
Documentation Requirements for Modifier 52 & 53 Modifier 52 – Reduced Services * Surgical Procedures: An operative report and a concise statement on how the service performed differs from the usual. * Non-Surgical Procedures: Provide a concise...
by Medical Billing | Jul 22, 2016 | CPT modifiers
Carriers may receive claims for surgical procedures with more than one surgical modifier. For example, since the global fee concept applies to all major surgeries, carriers may receive a claim for surgical care only (modifier “-54”) for a bilateral surgery (modifier...
by Medical Billing | Jul 19, 2016 | CPT modifiers
Allowable Adjustments Effective January 1, 2000, the replacement code (CPT 69990) for modifier -20 – microsurgical techniques requiring the use of operating microscopes may be paid separately only when submitted with CPT codes: 61304 through 61546 61550 through...
by Lori | Jul 15, 2016 | CPT modifiers
Modifier KX is used to confirm requirements outlined in the appropriate Local Coverage Determination (LCD), are met for the procedure billed. By adding modifier KX to a claim, you are stating that your claim has met specific documentation requirements in the policy,...
by Medical Billing | Jul 13, 2016 | CPT modifiers
Coding a Facility Claim Procedure, Modifier and Diagnosis Codes – A critical element in claims filing is the submission of current and accurate codes to reflect the services provided. Correct coding is essential for correct reimbursement. We...
by Lori | Jul 9, 2016 | CPT modifiers
Modifier 77 Key Points/Instruction/What you need to know Modifier 77 is used to report a repeat procedure by another physician and is appended to the repeat procedure to: • Report the same service provided by another physician. • Indicate that a basic procedure or...
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