Distinct Procedural Service – Medicare modifier 59

by | Aug 26, 2010 | CPT modifiers

Modifier 59 Fact Sheet Definition: • Distinct Procedural Service identifies procedures/services not normally reported together, but appropriately billable under the circumstances. Appropriate Usage: • Documentation indicates two separate procedures performed on the...
Medicare modifier 58 and appropriate usage

Medicare modifier 58 and appropriate usage

by | Aug 26, 2010 | CPT modifiers

Modifier 58 Staged or Related Procedure or Service by the Same Physician During the Postoperative Period Definition: • Indicates a staged or related procedure or service by the same physician during the postoperative period Modifier “-58” (Staged or related...

Medicare modifier 57 – when to use

by | Aug 23, 2010 | CPT modifiers

Modifier 57 Fact Sheet Definition: • Indicates an Evaluation and Management (E/M) service resulted in the initial decision to perform surgery either the day before a major surgery (90-day global) or the day of a major surgery. Appropriate Usage: • Append where the...

Usage of Medicare modifier 55

by | Aug 23, 2010 | CPT modifiers

Modifier 55 Fact Sheet Definition: Modifier 55 –  Postoperative Management Only • Indicate a physician, other than the surgeon, is billing for part of the outpatient postoperative care. • Also, used by the surgeon when providing only a portion of the...

Surgical care Modifier – 54

by | Aug 20, 2010 | CPT modifiers

Modifier 54 Fact Sheet Definition: • Modifier 54 indicates that the surgeon is billing the surgical care only. Appropriate Usage: • When all or part of the postoperative care is relinquished to a physician who is not a member of the same group • Appended to the...