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...

Medicare modifier 53 – discontinued procedure

by | Aug 11, 2010 | CPT modifiers

Modifier 53 Discontinued Procedure (professional services only) Instructions This 53 modifier allows the physician community to state the surgical procedure was discontinued due to extenuating circumstances or a threat to patient well-being.   Correct Use...

Three types of CPT codes

by | Aug 11, 2010 | CPT modifiers

What are CPT codes ? The Current Procedural Terminology® (CPT®) code set is maintained by the American Medical Association through the CPT Editorial Panel.  The CPT code set accurately describes medical, surgical, and diagnostic services and is designed to...

Reduced Service – Medicare modifier 52

by | Aug 9, 2010 | CPT modifiers

Modifier 52 Fact Sheet Definition: • Reduced Service reports a partially reduced or eliminated service or procedure. Appropriate Usage: • Procedures for which services performed are significantly less than usually required may be billed with the “52″ modifier. •...

Medicare modifier 51 – Multiple surgery

by | Aug 9, 2010 | CPT modifiers

Modifier 51 Multiple Procedures.  When multiple procedures, other than Evaluation and Management (E/M), Physical Medicine and Rehabilitation services or provisions of supplies (e.g., vaccines) are performed at the same session by the same individual, the primary...

Medicare modifier 50 – bilateral procedure

by | Aug 6, 2010 | CPT modifiers

Modifier 50 Fact Sheet Definition: • Bilateral Procedure performed at the same session on an anatomical site. Appropriate Usage: • When the procedure is done bilaterally AND the MPFSDB indicator for the procedure is “1” or “3” report the...