All About medical Billing, Coding & Claims Modifiers

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Importance of Using permissible Modifiers:

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1. The doctor performed complicated procedures

2. The course performed was bilateral

3. The E/M service was done on the same day of the procedure

4. The course was increased or decreased

5. The course has both professional and technical component

6. The course was performed by other provider (Anesthesiologist, Surgeon bodily Therapist, Speech Pathologists etc.)

7. course on whether one side of the body was performed

8. The E/M service was in case,granted within the postoperative period

9. The E/M service resulted to Decision of Surgery

10. Unusual Circumstance

Maximize your repayment for bilateral procedures by using the correct modifier.

Bilateral Modifier (-50)

Depending upon the insurance payer, processing claims with bilateral course should be paid 150%

Medicare Part B requires one particular line of bilateral course code with Modifier 50. They ordinarily process the claim with 150% reimbursement. But again, you have to check on this in your state and in your region.

Some industrial insurance would prefer Two Lines of the same code, once with 50, second without 50. Then second modifier on the 1st line is Rt or Lt, modifier Rt or Lt on second line, with 1 unit of service each code. Must be reimbursed at 150%

Some industrial insurance would prefer two lines of the same code with modifier Lt or Rt on each line with 1 unit of service each code. Must be reimbursed at 150%

Always check on your Physician's Fee agenda if the course code is billable as bilateral J.

Using Lt & Rt modifier is used to specify which side of the body the course was done by the physician. Medicare Part B based on my experience requires specific modifier, whether Lt or Rt. Example you may record course 64626 done on the Right C4-C7 Facet Joint Nerve Ablation as 64626-Rt.

Modifier -26. professional Component.

Example: record course code 77003 - Fluoroscopic advice and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid,, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint) along with neurolytic agent destruction) with modifier -26 to indicate the physicians professional Component only repayment and not technical component. If the provider's office owns the fluoroscopic equipment, do not append -26 modifier.

Modifier -25. Significant, Separately Identifiable assessment and administration service by the Same doctor on the Same Day of the course or Other Service.

Example: record E/M code 99213 (Office or other inpatient visit for the assessment and administration of an established patient) with Modifier -25 for course code 20610 Knee Joint Injection done on the same day of the procedure. Modifier -25 indicates importance and detach identifiable E/M service covering the course done on the patient. Do Not use modifier -25 to record E/M service that resulted for preliminary decision for surgery.

Instead use modifier -57 for Decision for Surgery

Modifier -24. Unrelated assessment and administration service by the Same doctor while Postoperative Period

Example: record E/M code 99213 with Modifier -24 if the inpatient came back while the postoperative period. The doctor must identify this service as completely unrelated with the recent course done on the patient. A detailed medical documentation is a good withhold for medical necessity.

Modifier -51 for complicated Procedures.

Modifier -59 for certain Procedural Service

Modifier-Gp Services Rendered under inpatient bodily Therapy plan of care

Modifier-Go Services Rendered under inpatient Occupational Therapy plan of care

Modifier -Gn Services Rendered under inpatient Speech analysis plan of care

Always check your up to date Cpt Book. Check the Cms Cci Edits. Check the insurance payor's policies and guidelines.

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