Tuesday, June 8, 2010

Unrelated procedure or service by the same physician during a postoperative period - 79

Part - A  Level I Modifiers 79

Description Unrelated procedure or service by the same physician during a postoperative period.

Required for Claims
Hospital Outpatient Prospective Payment System (OPPS)

Type of Bill: 12X, 13X

Coding Guidelines Generally applied to surgical (CPT 10000-69990), radiological procedures (CPT 70010-79999) and other diagnostic services (CPT 90281-99569)

General Guidelines

A. Modifier –79 is used to indicate that the performance of a procedure or service by the same physician during the post-operative period was unrelated to the original procedure that was performed earlier in the day.

B. Apply the –79 modifier to the second procedure or service provided on the same day.

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