This modifier may only be submitted with surgery codes. For E/M services performed in the global period of a surgery, refer to CPT® modifiers 24, 25 and 57. An operating room for this purpose is defined as a place of service specifically equipped and staffed for the sole purpose of pe...
UnitedHealthcare ® Oxford Administrative Policy Comprehensive and Component CPT Codes Policy Number: ADMINISTRATIVE 043.13C Effective Date: January 1, 2023 Instructions for Use Table of Contents Page Applicable Lines of Business/Products ... 1 Purpose ... 1 Definitions ......
The correct use of a 25 modifier is usually indicated when two distinct diagnoses are made during the visit. However, under the right circumstances, only one diagnosis may be required. For more detailed information, visit our fact sheet about using this modifier. CPT Modifier 26 Professional ...
A patient underwent a diagnostic colonoscopy to determine the reason for abnormal bowel movements. Using a snare, the physician removed a benign polyp of the cecum. What is the correct CPT code and diagnosis? What modifier will be appended to ...
2. Modifier –25 may be appended only to E/M service codes and then only for those within the range of 99201-99499. For outpatient services paid under OPPS, the relevant code ranges are: 99201-99215 (Office or Outpatient Services)
CMS states that when billing 97140 and 97530 (therapeutic activities; direct, one-on-one patient contact by the provider; or use of dynamic activities to improve functional performance, each for 15 minutes) for the same session or date, modifier 59 is only appropriate if the therapist performs...
2008 144 PART 2 Claim Coding CPT only © 2006 American Medical Association. All rights reserved. Procedure codes, like diagnosis codes, are an important part of the medical billing process. Standard procedure codes are used by physicians to report the medical, surgical, and diagnostic services ...