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...

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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...

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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...

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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...

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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...

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2015 Medicare Modifier 59 Changes with 4 New Modifiers
Nov29

2015 Medicare Modifier 59 Changes with 4 New Modifiers

This may impact your reimbursement in the coming New Year 2015! Make sure you and your staff knows about these new changes. Let’s welcome the new year 2015 with more easy to use Modifier 59 and say hello to its the new 4 X’s HCPCS modifers added by CMS. 2015 Medicare Modifier 59 Changes If you are familiar with the CCI Edits or the Correct Coding Initiative Edits? isn’t it that Modifier 59 has always been the modifier that comes to our mind to bypass edits with column 2 “1”? We use modifier 59 for the purpose of telling the payers that the procedure(s) was performed as “DISTINCT PROCEDURAL SERVICE” A little background – why are we using Modifier -59. The Procedural Service can be “Distinct” due to the fact that it was a same-day procedure performed on: a different body site or organ system. a different or separate lesion. a different area of injury a different procedure a separate incision or excision a different day of encounter a different practitioner a different session a distinct and independent procedure/surgery/encounter from other services performed. The CPT Manual clearly defines Modifier -59 as follows: “Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. Documentation must support a different session, different procedure or surgery, different site or organ system. separate incision/excision, separate lesion, or separate injury not ordinarily encountered or performed on the same day by the same individual. However, when another already established modifier is appropriate, it should be used rather than Modifier 59. Only if no more descriptive modifier is available, and the use of Modifier 59 best explains the circumstances, should Modifier 59 be used. NOTE: Modifier 59 should not be appended to an E/M service. To report a separate and distinct E/M service with a non-E/M service performed on the same date, see Modifier 25 Modifier 59 and other NCCI-associated modifiers should NOT be used to bypass a PTP edit unless the proper criteria for use of the modifier are met. Documentation in the medical record must satisfy the criteria required by any NCCI-associated modifier that is used. If you are audited for misuse of Modifier 59, your documentation will be checked so it must clearly state that the criteria was met CMS introduced the 4 New Modifiers for 2015 (not to replace Modifier 59 – just not yet!). These 4 new modifiers were developed for more specificity...

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