Medicare claim modifers

Other Modifiers for Medicare Claims AP Determination of refractive state was not performed in the course of diagnostic ophthalmological examination. No effect on payment. AQ Physician providing a service in an unlisted health professional shortage area (HPSA). For...

Out – patient ASC modifiers – 73 , 74

Out-patient Hospital/Ambulatory Surgical Center (ASC) Modifiers 73 Discontinued out-patient hospital/ambulatory surgical center (ASC) procedure prior to the administration of anesthesia – Due to extenuating circumstances or those that threaten the well being of...

Distinct procedural service – Modifier 59

Part – A  Level I Modifiers 59 Description Distinct procedural service. Required for Claims Hospital Outpatient Prospective Payment System (OPPS), Free-Standing Physical Therapy/Speech-language Pathology, Skilled Nursing Facility, End Stage Renal Disease...

Bilateral Services and CPT Modifier 50

Bilateral services are procedures performed on both sides of the body during the same operative session or on the same day. The modifier “50” is not applicable to procedures that are bilateral by definition or their descriptions include the terminology as...