CodingIntel

Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

Surgical Modifiers

This article includes a list of surgical modifiers with definitions, guidelines for billing multiple surgical procedures, and citations.  Members can also download the Global Surgery Coding Guide. Some of the information in this article and in the billing guide is the same.

Billing for Surgical Services

Before submitting a claim that has more than one line item for surgical services, a coder needs information. Most surgical practices subscribe to a program that makes looking up global days and bundling edits relatively easy.

  • Check the Medicare Fee Schedule Database for the global days for each surgical service.
  • Check the NCCI edits for bundling.
  • Payment for a surgical procedure includes certain pre-operative, intra operative, and post-operative care.

Related Issues: Surgical Modifiers in the Global Package

CMS instructions on the global surgical package, including the use of modifiers can be found here: http://www.cms.hhs.gov/manuals/iom/List.asp

Publication 100-04, Chapter 12, Section 40

Look in the CPT® book for complete descriptions of all modifiers.

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- Betsy Nicoletti
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Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.