I work for a hospitalist group. Our physician billed a critical care 99291 with 36556 (insertion of non-tunneled centrally inserted central venous catheter) and a 31500 (intubation). I know I need to append a modifier 25 to the 99291, however I can’t seem to figure out what (if any) modifiers to use on the two procedures. Do I need a modifier 51 on the 36556? Help please and thank you!
Click here for more sample CPC practice exam questions with Full Rationale Answers
Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page
Tag Archives: Modifiers
New Rules Issued for Modifiers 59, XE, XS, XP, and XU
The Centers for Medicare & Medicaid Services (CMS) issued Transmittal 2259, a modification to the claims processing logic for Modifiers 59, XE, XS, XP, and XU, on February 15, 2019. These modifiers are only processed when applied to the Column 2 code in a bundled pair per CCI as long as the modifier indicator is 1. […]
The post New Rules Issued for Modifiers 59, XE, XS, XP, and XU appeared first on AAPC Knowledge Center.
Medicare and coding coronary same branch modifiers
If I remember correctly, Medicare does not pay a branch of the same vessel. For ex. stent to the mid RC and stent to the posterior descending. The patient has Medicare primary and AARP secondary. Is there a specific modifier that needs to be applied to the second stent?
Thank you
Using modifiers on laceration repair codes ex. 12001, 12011, etc.
Hi!
When entering CPT codes for laceration repair done in the ED, should I be adding a modifier to indicate specifically where the laceration is?
EX: 12001 – adding a modifier LT for a repair done on the left knee?
thanks!
post operative modifiers
When you have a patient that has surgery say CMC arthroscopy and then comes back in office 14 business days later for a post operative check and an xray is take of the CMC joint, what Modifier is attached to the Xray?
Texas Work Comp Modifiers for 99080
Hello –
Does anyone know where I can find a list of appropriate modifiers for Texas work comp.
We filled out the DWC073 and DWC069 stating the patient could now return to work.
We billed our E/M code as well as the 99080 but used modifier 73.
SOMR has kicked it back for the procedure code is inconsistent with the Modifier used or Required modifier is missing.
Any help would be greatly appreciated 
X-Ray modifiers
Hello,
We are a family practice clinic with Digital X-ray equipment.
We also send the x-rays out for reading and we pay the fee to the radiologist.
How should we be coding the claim to get reimbursed for both the Technical Component and the Professional Component?
i.e.:
72100 X-RAY EXAM OF LOWER SPINE – Modifiers: TC, 76
72100 X-RAY EXAM OF LOWER SPINE – Modifiers: 26, 76
I appreciate the help in advance!
Rick
Radiology coding modifiers for comparison-only views
Example: patient is being x-rayed for pain in left knee. Physician’s report only cites left knee pain as diagnosis. Three views are taken of the left knee. One view is also taken of right knee for comparison purposes. Would it be appropriate to use diagnosis code M25.562 for both procedures 73560 with modifier RT as well as 73562 with modifier LT? If not, what else would you think is correct??
9 New HCPCS Modifiers to Use
The 2019 HCPCS Level II code set includes an unusual nine new Modifiers that help medical coders and billers accurately report services recently adopted or changed by Medicare. Some are already effective; others are effective January 1, 2019. Modifiers CO and CQ Modifiers CO and CQ identify therapy services provided by an occupational therapy assistant […]
The post 9 New HCPCS Modifiers to Use appeared first on AAPC Knowledge Center.
Chiropractic Modifiers with ABN
Can someone please answer this question? We have a voluntary ABN for a service Medicare never covers. When we use the GX/GY Modifier for G0283 and 97012 codes, Medicare says this is an "inconsistent modifier(s)" for the service. I have researched this everywhere I can think of, including ChiroCode which says GX/GY Modifier is correct. I would appreciate any information. I am not a newbie, this is just something that started about 8 months ago with Medicare.