How much is Allowed During the Global Period Using Modifier 58, 78 and 79
Jan17

How much is Allowed During the Global Period Using Modifier 58, 78 and 79

How much is Allowed During the Global Period Using Modifiers 58, 78 and 79 These 3 Modifiers are commonly used when the service was rendered during the Surgical Global Period. And you might be wondering how are they being reimbursed based on the allowable amount? Well, here’s what I thought I should be sharing to you. Modifier 58  What it indicates, “staged or related procedure or service by the same physician during the post-operative period.” when; planned at the time of the original procedure, or staged; it is more extensive than the original procedure; or a therapy following a diagnostic surgical procedure. *** DO NOT use Modifier 58 if the Procedure is Converted from Laparoscopic to Open Procedure Reimbursement: 100% of the allowable amount Modifier 78  What it indicates,  “unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the post-operative period. When this procedure is related to the first and requires the use of an operating or procedure room, it may be reported by adding modifier 78 to the related procedure.” Reimbursement: Likely up to 80% of the allowable amount; why? well, its because it is related to the procedure that is within the global period. Modifier 79  What it indicates, “unrelated procedure or service by the same physician during the post-operative period.” Reimbursement: 100% of the allowable amount Need Immediate Help?  CHAT WITH US/TEXT/CALL  (888) 822-0862 Email: pinky.maniri@gmail.com  We Offer CONSULTING SERVICES  We always OVER-DELIVER! 100% Satisfaction Guaranteed. Or we will return your money! We offer hourly coding consulting time on certain specialty only: Pain Management General Surgery Anesthesiology Physical Medicine and Rehabilitation Dermatology Obesity Medicine Sports Medicine Neurology Spine and Orthopedic Surgery Physical Therapy / Occupational Therapy / Speech Pathology Chiropractic Services Workers Comp and Motor Vehicle Accident Cases Medical Billing, Coding, Reimbursement and E/M Questions? We can help you navigate your practice on how to INCREASE REVENUE by looking at additional Services that you can possibly do in your Practice based on your Specialty. Other Services We Offer: Setting up a Medical Practice Revenue Cycle/Reimbursement Management Insurance Credentialing and Contract NegotiationsMedicare Enrollment and Credentialing Chart Auditing Staff Training Compliance Program Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

Read More
When to Use Modifier 33 Preventive Service
Mar23

When to Use Modifier 33 Preventive Service

// When to Use Modifier 33 Preventive Service Let’s look at this CPT Modifier 33 By Definition, Modifier 33 – Preventive Service: When the primary purpose of the service is the delivery of an evidence-based service in accordance with a US Preventive Services Task Force A or B rating in effect and other preventive services… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

Read More
CPT Modifiers in Billing and Coding – What Are They?
Mar15

CPT Modifiers in Billing and Coding – What Are They?

CPT Modifiers in Billing and Coding What are they? Searched keyword:  CPT Modifiers in Billing and Coding The physician performed multiple procedures The procedure performed was bilateral The E/M service was done on the same day of the procedure The procedure was increased or decreased The procedure has both professional and technical component The procedure… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

Read More
What Modifier for Global Surgery Should You Use?
Jan06

What Modifier for Global Surgery Should You Use?

Modifier for Global Surgery  (when used during the Surgical Global Days) Modifier 24 Evaluation and management service performed during the postoperative period for reasons unrelated to the original surgical procedure. Modifier 57 Evaluation and Management service involving the initial decision to perform surgery either the day before or the day of a 90-day major surgery. Append when the decision to perform surgery is made the day before or day of a 90-day major surgery. An Evaluation and Management service resulted in the initial decision to perform surgery during the E/M encounter. Let’s describe this modifier 57: An OB/GYN Doc sees a patient who complains with severe abdominal pain. It turned out (through ultra sound, radiology and all other diagnostic testing and documentations), the patient is having an ectopic pregrancy. The OB/GYN performs the laparoscopic surgery on the same day. The E/M encounter will then be reported with modifier 57 which resulted to decision for surgery. The laparoscopic surgery should also be reported as performed on the same day without a modifier. The following are your Modifier for Global Surgery (Postoperative) While the patient is covered by a global period, the following three modifiers may be appended to surgical CPT codes to indicate that an unrelated surgical procedure is being reported: Modifier 58: Staged or related procedure or service by the same physician or other qualified healthcare professional during the postoperative period Modifier 78: Unplanned return to the operating/procedure room by the same physician or other qualified healthcare professional following initial procedure for a related procedure during the postoperative period Modifier 79: Unrelated procedure or service by the same physician or other qualified healthcare professional during the postoperative period References you can read: (Modifier for Global Surgery) Chapter 12 – Physicians Nonphysician Practitioners What Modifier for Global Surgery Should You Use?  How to Use Billing Modifiers in Medical Coding Searched Keyword: Modifier for Global Surgery Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

Read More

How to Use Billing Modifiers in Medical Coding

// How to Use Billing Modifiers in Medical Coding Using Proper and Right Modifiers for Medical Specialty Services Why do we have to know how to properly use the right modifiers? Well, here are the simple reasons why we need modifiers: The physician performed multiple procedures The procedure performed was bilateral The E/M service was done… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share what you just found from this website! Go ahead - please click "SHARE"EmailTweetShare on...

Read More
2015 Useful New Modifiers for Physical Therapy Billing and Coding
Dec02

2015 Useful New Modifiers for Physical Therapy Billing and Coding

Beginning January 1, 2015 – CMS had developed 4 new Modifiers that can be useful for therapy service provider. As a consultant helping many of my therapy service provider-clients, I think this could would be more appropriate to use than the modifier 59 These new modifiers are subsets of Modifier 59 For example, using modifier XS when you are treating a patient with two different anatomic site (knee, and back) … this is an appropriate modifier to use. 97110 –                (DX Pointer- Code V43.65, 717.9) 97110 – XS          (DX Pointer- Code 724.4) Say hello to your 2015 Useful New Modifiers for Physical Therapy Billing and Coding Modifier XE Separate encounter: A service that is distinct because it occurred during a separate encounter Modifier XP Separate practitioner: A service that is distinct because it was performed by a different Modifier XS Separate structure: A service that is distinct because it was performed on a separate organ/structure Modifier XU Unusual non-overlapping service: The use of a service that is distinct because it does not overlap usual components of the main service Reference: 2015 CMS Modifier 15 Changes Transmittal 1422 CR 8863 Although, CMS will continue to recognize Modifier -59 but you have to make sure you will only utilize modifier 59 when there is no other specific modifier that may describe your “distinct” procedure service. When using this modifier, Medical Documentation is vital and essential to support medical necessity. This must be well-documented on the patient’s medical record. Searched Keywords: pt new eval codes, occupational therapy cpt codes, physical therapy cpt codes 2017, cpt code 97140, cpt code 97530, cpt code 97001, cpt code 97112, cpt code 97535, cpt code 97014, revenue cycle management, how much is clinicient, how much is webpt, webpt versus clinicient, webpt review, webpt documentation, webpt reviews, why use webpt, webpt versus clinicient, cpt 97001, 2017 new, physical therapy codes, out of network physical therapist, out of network doctor, out of network provider, billing functions for physical therapy, looking for physical therapy billing service, physical therapy billing service in new jersey, billing percentage, how to bill physical therapy, modifier go, modifier kx, medicare physical therapy cap, 97110 cpt, cpt 97140, cpt code 97112, cpt code 97116, cpt 97001, physical therapy cpt codes, cpt code 97035, cpt code 97014, cpt code 97535, medicare pt audit, how to bill medicare for pt, how to bill medicare for physical therapy, how to start a pt practice. how to start a physical therapy practice, physical therapy credentialing, rcm Find this article useful? Please comment below and share what you just found from this website! Go...

Read More