modifiers Archives

Problematic Modifiers – 22, -52, -58, -78, -79 | Webinar

Event date June 19th, 2025

Guest presenter Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O

This webinar will focus on selected CPT® modifiers that tend to be problematic for coders and claims processing. The instructor will focus on the application of modifier-22 and -52 including commonalities and differences as stated by the AMA as well as supportive citations from the Medicare Claims Processing Manual.

Modifier 51 or 59? How to Know Which to Bill?

Modifier 51 and 59 are both used on second and subsequent surgical procedures, when performed on the day of a primary procedure See also Modifier 59 quick reference sheet There are two modifiers commonly used in surgical specialties when billing two or more procedures at the same encounter. Appending the correct modifier increases the likelihood […]

Modifier 57

Decision for Surgery. An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E/M service. The payment for major surgery includes E/M services provided on the day of and the day before a major surgical procedure, unless it […]

Modifier 24

Understanding E/M modifiers is important for both revenue and compliance. Failing to apply the correct modifier reduces revenue. Applying the wrong modifier or using it when it is not accurate is a compliance issue and puts the practice at risk for payback and disclosures. For additional information, see the article on Global Surgical Package. Modifier […]

Coding Guide – Global Surgery

This guide from CodingIntel explains surgery coding guidelines and the global period for procedures, and includes the contents of our original CPT® and HCPCS Modifier Guide.

Surgical Modifiers

This article includes: Surgical modifiers with definitions Guidelines for billing multiple surgical procedures Modifiers in the post-op period Avoiding CPT® modifier mishaps 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 […]

Can I Get Paid for…an Office Visit the Same Day as a Minor Procedure

Can you bill an E/M service on the same day as a minor procedure? Sometimes yes, sometimes no. The decision to perform a minor procedure is included in the payment for the procedure, unless a significant and separate E/M is needed, performed and documented. Watch this short video to learn more.

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