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how to use medical and surgical modifiers

8/29/2018

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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.

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    10 Common Reasons Claims Gets Denied And Reject
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    Spinal Fusion Billing And Coding
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