Assistant surgery modifier

Assistant at Surgery Modifier Fact Sheet Definition: • An “assistant at surgery” is a physician who actively assists the physician in charge of a case in performing a surgical procedure. The “assistant at surgery” provides more than just ancillary services. Facts: •...

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 dates of service on or after January 1,...

CPT modifiers – full overview

What is CPT Modifiers  CPT Modifiers provide additional information to payers to make sure your provider gets paid correctly for services rendered. CPT modifiers are used to provide additional information to insurance payers for procedures or services that have...

team of surgeons – cpt modifier 66

Modifier 66 Fact Sheet Definition: • If a team of surgeons (more than two surgeons of different specialties) is required to perform a specific procedure, each surgeon bills for the procedure with a modifier “-66.” Appropriate Use: • The MPFSDB identifies certain...

Two surgeons perform a specific procedure – Modifier 62

Modifier 62 Fact Sheet Definition: • Two surgeons (each in a different specialty) are required to perform a specific procedure Appropriate Use: • If two surgeons (each in a different specialty) are required to perform a specific procedure, each surgeon bills for the...
Medicare modifier 58 and appropriate usage

Medicare modifier 58 and appropriate usage

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...

Distinct Procedural Service – Medicare modifier 59

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...