Question: Why and when should we use modifier CS? Answer: Use modifier CS on visits related to testing for COVID-19. Modifier CS: cost … [Read more...]
Modifier CS: cost sharing for COVID-19 testing and visits related to testing
Effective retroactively to 3/18/20, there is no cost sharing allowed for COVID-19 testing or for the evaluation visits related to the testing … [Read more...]
Use of Modifier 58 for Dermatology
The most common use of modifier 58 in dermatology is for re-excision of a lesion because the margins weren’t clear, based on the pathology … [Read more...]
Modifier 51 or 59? How to know which to bill?
There are two modifiers commonly used in surgical specialties when billing two or more procedures at the same encounter. Appending the correct … [Read more...]
Coding multiple procedures | Examples with modifiers
Biopsies and lesion destruction codes are often performed at the same patient visit. This leads to questions about bundling and modifiers. There are … [Read more...]
Using Modifier 59 | Cheat Sheet
Modifier 59 is referred to by CMS as the modifier of last resort. It is often used when modifier 51 is the more accurate modifier. This quick … [Read more...]
Using Modifier 33 | Cheat Sheet
Modifier 33 is a CPT modifier used to identify medical care whose primary purpose is delivery of an evidence based service, based on recommendations … [Read more...]
Using Modifier 25 | Cheat Sheet
Use of Modifier 25 may be applicable when an E/M service is provided on the same day as a procedure, a preventive medicine service, or other medical … [Read more...]
Coding Guide – CPT® and HCPCS Code Modifiers
Table of Contents Modifier introduction Initial evaluation – minor procedure E/M service same day Initial evaluation – major procedure … [Read more...]
Billing physician services for hospice patients | Cheat sheet
Medical practices find the hospice modifiers confusing, and confusion leads to denials and payment delays. Use the decision trees below to help you … [Read more...]
Billing medical practice services for patients on hospice
Overview of hospice care Medicare beneficiaries who have a terminal illness with a life expectancy of six months or less can elect to have their … [Read more...]
Can two practices split the post-op office care of a patient?
Question: Can two practices split the post-op office care of a patient? Answer: No. Although the operative and post-operative portions of the … [Read more...]
Do I need Modifier 52 for this repair?
Question: Can you please give me your opinion on a coding case? We have a surgical oncologist that performed an excision of malignant skin … [Read more...]
Wound Care CPT® Codes 11042 and 29580
Wound care CPT® Codes 11042 and 29580 Question: Our wound care physician billed for debriding a wound on the right foot and applied an Unna boot … [Read more...]
Selecting CPT® rules for excision of skin lesions
Many medical practices perform skin procedures. A patient may see a dermatologist, a family physician or a surgeon when the time comes to find out, … [Read more...]
Everything you want (and need) to know about E/M services
Evaluation and Management (E/M) services account for 30% of the revenue paid by Medicare for all physician services. For many specialties, E/M codes … [Read more...]
Reporting Excision of Multiple Lesions of the Same Size
Question: The doctor I work with excised two benign lesions from a patient’s arm, of the same length. Do I add them together and report one code? … [Read more...]
Modifiers in the Post-op Period | Global Surgical Package
Although there is a single payment for surgical procedures that have 0, 10 and 90 global days, there are frequent instances in which the surgeon … [Read more...]
More modifier mishaps | CPT® Modifiers
Some modifier errors are easily avoided by experienced coders or practice management software with an editing function to stop incorrect claims before … [Read more...]
Co-surgery, Team surgery, Assistant at surgery
Modifiers for co-surgery, team surgery and assistant at surgery CPT® has specific modifiers for co-surgery, team surgery and assistant at surgery. … [Read more...]