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How to use MODIFIERS for MEDICAL AND GLOBAL SURGERY Encounters - GoHealthcare is a Leader in Revenue Cycle Management. I have shared a lot of guidelines on each of this modifier. But today, this blog post will cover from Modifier 22 to Modifier 99. So are you ready? Make sure to click on "DIG DEEPER" for learn more and read more on clinical scenario samples. All of these guidelines are based on Medicare's Guidelines. References are attached on each guideline. I strongly believe 98% of all the commercial payers does follow Medicare's Guidelines. Period. Modifier 22
Increased Procedural Services (Dig Deeper to learn more ... CLICK HERE) Modifier 23 Unusual Anesthesia Modifier 24 Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period (Dig Deeper to learn more ... CLICK HERE) Modifier 25 Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service Modifier 26 Professional Component Modifier 27 Multiple Outpatient Hospital E/M Encounters on the Same Date Modifier 32 Mandated Services Modifier 33 Preventive Services Modifier 47 Anesthesia by Surgeon Modifier 50 Bilateral Procedure (Dig Deeper to learn more ... CLICK HERE) Modifier 51 Multiple Procedures Modifier 52 Reduced Services Modifier 53 Discontinued Procedure Modifier 54 Surgical Care Only Modifier 55 Postoperative Management Only Modifier 56 Preoperative Management Only Modifier 57 Decision for Surgery (Dig Deeper to learn more ... CLICK HERE) Modifier 58 Staged or Related Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period (Dig Deeper to learn more ... CLICK HERE) Modifier 59 Distinct Procedural Service (Dig Deeper to learn more ... CLICK HERE) Modifier 62 Two Surgeons Modifier 63 Procedure Performed on Infants less than 4 kg Modifier 66 Surgical Team Modifier 73 Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia Modifier 74 Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure After Administration of Anesthesia Modifier 76 Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional Modifier 77 Repeat Procedure by Another Physician or Other Qualified Health Care Professional Modifier 78 Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period Modifier 79 Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period (Dig Deeper to learn more ... CLICK HERE) Modifier 80 Assistant Surgeon Modifier 81 Minimum Assistant Surgeon Modifier 82 Assistant Surgeon (when qualified resident surgeon not available) Modifier 90 Reference (Outside) Laboratory Modifier 91 Repeat Clinical Diagnostic Laboratory Test Modifier 92 Alternative Laboratory Platform Testing Modifier 95 Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System Modifier 96 Habilitative Services Modifier 97 Rehabilitative Services Modifier 99 Multiple Modifiers
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ABOUT THE AUTHOR:
Ms. Pinky Maniri-Pescasio is the CEO and Founder of GoHealthcare Consulting. She is a National Speaker on Practice Reimbursement and a Physician Advocate. She has served the Medical Practice Industry for more than 25 years as a Professional Consultant. Archives
August 2018
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