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Re: Medicare Modifiers, GA, etc.
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Doo
Re: Medicare Modifiers, GA, etc.
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Sep 9 02 2:12 PM
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My Recent Posts
BASIC MODIFIER GUIDELINES
1. Assign modifiers that have payment impact in the first position
2. Assign modifiers for anatomical designation in the second position
3. Assign modifiers for specific specialties if appropriate
4. Assign modifiers 80, 81 or 82 for a MD assistant at surgery in the first position.
5. Assign modifier AS for non- MD assistant at surgery in the first position.
6. Assign modifier 50 ONLY for bilateral procedures. Report the procedure code on both lines with the -50 modifier on the second procedure line.
7. Assign modifier 59 ONLY when distinct, independent and separate multiple procedures are provided. Documentation may be required to support the use of modifier 59.
8. Assign modifiers LT/RT in the second, third or fourth position if billing more than one modifier on a procedure. Information modifier only.
MODIFIERS:
25: Use when E/M service are separate, distinctly identifiable service from other services or procedures rendered. Do not use when E/M services that resulted in the decision to perform major surgery or on a surgical code
50: Bilateral procedures that are eligible for bilateral reimbursement, enter the procedure code modifier 50 on one line.
52: Use when a procedure was not completed in its entirety.
59: Use to clearly designate when distinct, independent and separate multiple procedures are provided, or when the procedure is not a component of another procedure. Documentation may be required to support the use of modifier 59.
80, 81, or 82: Use when MD performs assistant surgery. Must use same code as primary surgeon.
AS: Use when Non-MD performs assistant surgery. Must use same code as primary surgeon.
RT/LT: Can use RT/LT on any valid procedure code. Not used to indicate a bilateral procedure.
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Association News
Medical Billing & Coding Education from the MAB
Continuing Education
Management Advice and Training
Questions Asked More Than Once
Help Wanted - Billing and Coding
Non Billing Talk
The Venting Area (Clean posts please)
Medical Coding and Billing News
Fraud and Abuse
Health Insurance - Provider Contracting
ERISA
Tricare
Workers' Compensation
General Medical Billing Questions
Appeals
Accounts Receivables (A/R)
Refunds
Auto Accident Issues
Medisoft Technical Support
Medical Software Technical Support Questions Other than Medisoft. No Investigation Questions!
General Medical Coding Forum
CPT Coding Questions
HCPCS Coding Questions
ICD-9-CM Coding Questions
Evaluation & Management Coding Questions
Acupuncture Billing and Coding
Ambulance Coding and Billing
Cardiology Coding and Billing
Chiropractic Coding and Billing
Dental Billing and Coding
DME Coding and Billing
Emergency Department Coding and Billing
Family Practice Coding and Billing
Hospital Inpatient and Outpatient Coding
Hospital Billing, Appeals and Collections
Internal Medicine Coding and Billing
Laboratory Coding and Billing
Ophthalmology Coding and Billing
OB-GYN Coding and Billing
Pain Management Coding and Billing
Pediatric Coding and Billing
Podiatry Coding and Billing
Physical Therapy Coding and Billing
Psychiatry Coding and Billing
Radiology Coding and Billing
Surgery Coding and Billing
Neurology Coding and Billing
Urgent Care Coding and Billing
Provider Compliance
Billing Center Compliance
HIPAA
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Chiropractic Coding and Billing
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Medicare Modifiers, GA, etc.
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