Modifiers, as part of Current Procedural Terminology (CPT), indicate that a service was altered in some way from the stated CPT descriptor without changing the definition. The American Medical Association CPT modifiers are two-digit numeric codes listed after a procedure or Evaluation and Management...
Unique features of CPT codes: Structure: Each CPT code consists of a five-digit numerical identifier that corresponds to a specific medical procedure or service. Annual Updates: Managed by the American Medical Association (AMA) with input from professional specialty societies, including those focusing...
Use modifier 55 with the CPT procedure code for global periods of 10 or 90-days. Report the date of surgery as the date of service and indicate the date that care was relinquished or assumed. Physicians must keep copies of the written transfer agreement in the beneficiary’s medical record....
The other surgical codes will have Modifier 51 appended unless an exception applies (add-on, 51 exempt). Modifier 51 is used By the primary surgeon, assistant surgeon and ambulatory surgical facility to indicate that more than one surgery was performed by the same physician on the same patient...
used to indicate that an E/M service was provided on the same day as another procedure that would normally bundle under the National Correct Coding Initiative (NCCI). In this situation, CPT modifier 25 signifies that the E/M service was performed for a reason unrelated to the other procedure...
CPT codes 99000 and 99001 (handling fees) are not eligible for separate reimbursement. Correct Use The outside laboratory performs the procedure, unrelated to treating/reporting the physician In most cases, the lab furnishing the service would bill the claim Possible for one lab to bill service...
(It may be necessary to indicate another procedure was performed during the postoperative period of the initial procedure. When it is related to the first and requires the OR/Procedure room report by adding this modifier to the related procedure.) ...
The most common codes that will be used in Primary Care are related to conjunctivitis. The two categories related to conjunctivitis are found in the table below, but the most commonly used codes are: • H10.0 Mucopurulent conjunctivitis ...