Transcription
Reporting HospitalOutpatient ModifiersAudio Seminar/WebinarApril 17, 2008 Copyright 2008 American Health Information Management Association. All rights reserved.
DisclaimerThe American Health Information Management Association makes norepresentation or guarantee with respect to the contents herein and specificallydisclaims any implied guarantee of suitability for any specific purpose. AHIMA hasno liability or responsibility to any person or entity with respect to any loss ordamage caused by the use of this audio seminar, including but not limited to anyloss of revenue, interruption of service, loss of business, or indirect damagesresulting from the use of this program. AHIMA makes no guarantee that the useof this program will prevent differences of opinion or disputes with Medicare orother third party payers as to the amount that will be paid to providers of service.CPT five digit codes, nomenclature, and other data are copyright 2007 AmericanMedical Association. All Rights Reserved. No fee schedules, basic units, relativevalues or related listings are included in CPT. The AMA assumes no liability for thedata contained herein.As a provider of continuing education, the American Health InformationManagement Association (AHIMA) must assure balance, independence, objectivityand scientific rigor in all of its endeavors. AHIMA is solely responsible for control ofprogram objectives and content and the selection of presenters. All speakers andplanning committee members are expected to disclose to the audience: (1) anysignificant financial interest or other relationships with the manufacturer(s) orprovider(s) of any commercial product(s) or services(s) discussed in an educationalpresentation; (2) any significant financial interest or other relationship with anycompanies providing commercial support for the activity; and (3) if thepresentation will include discussion of investigational or unlabeled uses of aproduct. The intent of this requirement is not to prevent a speaker withcommercial affiliations from presenting, but rather to provide the participants withinformation from which they may make their own judgments.The faculty has reported no vested interests or disclosures regarding thispresentation.AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reservedi
FacultyCaroline Rader, MBA, MSHCA, CHC, is an associate director withNavigant Consulting, Inc.’s Revenue Cycle practice in Baltimore, MD. Ms.Rader provides consulting services to nationally recognized hospitalsystems, specifically related to outpatient billing compliance and chargecapture processes. She has been an author and speaker for the HealthCare Compliance Association and for the Maryland Chapter of AHIMA.Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA, is chair of theallied health department of Herzing College in Winter Park, FL. Ms. Safianhas had four books on coding published, with a fifth book on healthinformation management compliance in the works. She has been amember of AHIMA for many years, and sits on the Clinical Terminologyand Classification Practice Council. Ms. Safian is presently working on herPhD in Health Services Administration.AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reservedii
Table of ContentsDisclaimer . iFaculty .iiSeminar Objectives . 1Modifier Guidelines. 2Polling Question #1 . 3CPT Level I Hospital Modifiers . 4HCPCS Level II Modifiers . 5E/M ModifiersModifier 25 . 6Modifier 27 . 8Modifier 52 .10Polling Question #2 .13Modifiers 73 and 74.14Polling Question #3 .16Modifier 59 .16NCCI Edits .17Polling Question#4 .19Infusion Services .20Radiation Oncology.20Hepatitis C Antibody .21Modifier 91 .21vs. 59 (labs) .22Polling Question #5 .23Modifiers 76 and 77.23Modifiers LT and RT .24Modifier 50 .25Modifiers – Anatomical Sites.27Modifier GG .28Modifier GH .29Modifier TS .31Modifier CA.32Modifier GA .33Modifier GY.33Modifier GZ.34Modifier GN .34Modifier GO .35Modifier GP.35Modifier Q0.36Modifier Q1.37Modifier 58 .37Modifier 78 .38Modifier 70 .39Modifier Coverage and Reimbursement .40Resource/Reference List .41Audience QuestionsAppendixRevenue Impact Table.45AHIMA 2008 Audio Seminar Series
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsObjectives Review current AMA codingguidelines for modifierassignment Update coders' knowledge ofcurrent regulatory guidelineswhen assigning CPT modifiers1Objectives Review how to choose betweensimilar modifiers and applyapplicable modifiers using casescenarios Review the reimbursement impactof modifiers under OPPS2AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved1
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsWhat Are Modifiers?A two-digit code Placed after the CPT/HCPCSprocedure code Provides information aboutthe procedure May affect reimbursement 3Modifier Usage GuidelinesNot all procedure codes requiremodifiers Use of modifiers eliminatesappearance of unbundling andduplicate billing Not appropriate if narrativedescription of procedure applies todifferent body parts or indicatesmultiple occurrences 4AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved2
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier Usage GuidelinesModifiers apply to servicesperformed on the same calendarday Most specific modifier should beused first Ex – FA, F9 are used before LT, RT or 50 Hyphen should not be entered withmodifier (-50 vs. 50)Medicare Claims Processing Manual,chapter 4, sections 20.6-20.6.95Polling Question #1At your facility, who is responsible forhospital outpatient modifier assignment?*1 HIM*2 Patient Financial Services*3 Clinical Department(s)*4 Chargemaster (hard-coded)*5 Depends on modifier, department,and circumstance6AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved3
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsCPT Level I Hospital Modifiers Indicate special circumstances Multiple procedures performed Separately identifiable serviceperformed Procedure was discontinued If more than one Level I modifierapplies, both can be reportedtogether with the CPT/HCPCS7CPT Level I Hospital ModifiersExamples:2527505258597374767778798AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved4
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsHCPCS Level II ModifiersAdd specificity to the reporting ofprocedures If more than one Level IImodifier applies, the CPT/HCPCSis repeated with the additionalmodifier 9HCPCS Level II ModifiersExamples:CAE1 - E4FA - F9GAGGGHGNGOGPLCQ0 - Q1RC10AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved5
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsE/M Modifiers - Modifier 25 Significant, separately identifiableE/M service OPPS status indicator “V” (clinic oremergency department visit) Only reportable with E/M servicewhen the same physician on thesame day performed a diagnosticmedical or surgical and/ortherapeutic medical or surgicalprocedure is performed11E/M Modifiers - Modifier 25 Modifier is appended to E/Mcode OIG November 2005 report andCMS contractor awareness12AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved6
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsE/M Modifiers - Modifier 25Patient is brought to the hospitalemergency department for a possibleright ankle fracture. The providerevaluates the patient through the use ofplain film x-rays. Ultimately it is foundthat the patient has a bimalleolar anklefracture. The provider treats thefracture (closed without manipulation)and a short leg walking cast is applied.13E/M Modifiers - Modifier 25Moderate complexity EDvisit 27808-RT Closed treatment offracture 29425-RT Cast application 99283-2514AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved7
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsE/M Modifiers - Modifier 27 Multiple E/M encounters on samecalendar day OPPS status indicator “V” (clinic oremergency department visit) Modifier is appended to second orsubsequent E/MCondition code is required if E/M is insame revenue center on same dayRegulatory scrutiny15E/M Modifiers - Modifier 27An established patient is seen in theWound Care Clinic in the morning forevaluation of a new wound. She isevaluated; no treatment is performed.She is given a prescription. She fills theprescription and within hours has anallergic reaction. She is taken to the ED(same outpatient center) that evening.She is evaluated, treated, anddischarged. No surgical interventions,radiological exams, or laboratory testswere performed.AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved168
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsE/M Modifiers - Modifier 27Established patient,moderate clinic visit 99283-27 Moderate complexityED visit 9921317E/M Modifiers - Modifier 25/27In the previous scenario, the patientreceives a partial thicknessdebridement of her wound in theWound Care Clinic.18AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved9
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsE/M Modifiers - Modifier 25/27Established patient,moderate clinic visit 11040Debridement of skin,partial thickness 99283-27 Moderate complexity EDvisit 99213-2519Modifier 52Partially reduced ordiscontinued services Not for elective cancellation Services that do not requireanesthesia (see 73 - 74) 20AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved10
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 52 Usually identify interrupted orreduced radiology exams orother diagnostic services Code to the extent of theprocedure performed If no code exists, report theintended code Cannot be submitted with E/Mservices21Modifier 52Patient is scheduled for a GI series(CPT 74240). The examination couldnot be completed. The patient couldnot tolerate the barium.22AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved11
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 52 74240-52Upper GI series,without KUB23Modifier 52Patient is scheduled for a CT scanof the lumbar spine (CPT 72133)with and without contrast. Thepatient ended up only having a CTscan of the lumbar spine withoutcontrast.24AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved12
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 52 72131 CT of lumbar spine,without contrast25Polling Question #2Patient presents for a diagnosticcolonoscopy. The procedure cannot becompleted due to poor preparation.Would it be appropriate to report theprocedure as 45378-52?*1 Yes*2 No26AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved13
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 73 Procedure is discontinued or cancelledafter patient has been prepared forsurgery and/or prior to the induction ofanesthesiaApply to procedures requiringanesthesiaApply when the well-being of the patientis threatenedProcedure must be discontinued in theroom where the procedure was to beperformed in order to assign modifier27Modifier 74Procedure is discontinued orcancelled after administration ofanesthesia or after the procedurehas begun Apply when the well-being of thepatient is threatened Procedure must be discontinued inthe room where the procedure wasto be performed in order to assignmodifier AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved2814
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 73/74When one or more of the plannedprocedures is completed, reportthe completed procedure withoutModifier 73/74 When none of the procedures thatwere planned were completed,report the first procedure withModifier 73/74 29Discontinued Svs Decision Tree30AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved15
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsPolling Question #3Patient is scheduled for a diagnostic EGD. Asthe patient begins preparation, he developssignificant hypotension. The physiciancancels the procedure. Anesthesia has notbeen administered. The patient has not beenmoved into the procedure room. How shouldthis procedure be reported?*1 43235-73*2 43235-52*3 43235*4 None of the above31Modifier 59Identifies procedures not normallyreported together, but are done sounder certain circumstances Append modifier to the procedureconsidered distinct, independentor lesser service Cannot be appended to an E/Mservice 32AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved16
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 59Use only when another modifieris not more descriptive OIG and CMS contractor scrutiny 33Modifier 59 and NCCI EditsThe purpose of the NCCI edits isto prevent improper paymentwhen incorrect code combinationsare reported The NCCI contains two tables ofedits 34AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved17
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 59 and NCCI EditsThe Column One/Column TwoCorrect Coding Edits table and theMutually Exclusive Edits tableinclude code pairs that should notbe reported together NCCI edits are published by CMSand can be found online The NCCI Edit TableColumn 1/Column 2 CorrectCoding Edits apply to codecombinations where one of thecodes is a component of a morecomprehensive code. The edit allows payment for thecomprehensive code only 36AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved18
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsPolling Question #4Patient has an ECG (CPT 93005)completed in morning at theCardiology Clinic. The results areabnormal and the physician ordersa stress echocardiogram (CPT93350 and 93015) to be completedin the afternoon.continued37Audience Poll #4In reviewing the NCCI table Column 2 edits, wouldit be appropriate to report Modifier 59 for thiscombination?*1 Yes*2 No38AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved19
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 59 and Infusion ServicesReport Modifier 59 when An infusion that occurs at a seconddistinct encounter The second of two concurrent infusionswith two access sites are used and twodifferent drugs are administered Modifier 59 should not be appended toinfusion or injection codes to allowhydration to be billed primarily39Modifier 59 and Radiation Oncology Delivery 77401 - 77416 or 77418can be reported with Modifier 59on the same day as treatmentplanning and delivery whenperformed at separate sessions Devices 77332 - 77334 can bereported with Modifier 59 on thesame day as treatment planning40AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved20
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 59Antibodies for hepatitis C, totaland IgM are determined. Thereis a total of three tests withthree results.86803 x 1Hepatitis C antibody86803-59 x 1 Hepatitis C antibody41Modifier 91Repeat/identical clinicaldiagnostic laboratory testperformed on same day toobtain subsequent test values Separate specimens takenduring separate encounters Tests paid under the clinicaldiagnostic fee schedule 42AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved21
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 91 may NOT be usedRerun of tests to confirm results,a problem exists with thespecimen or equipment, or anyother reason when only a onetime result is required Other codes describe aseries of test results (e.g.,glucose tolerance tests) 43Modifier 91 versus 59 (Labs)Modifier 91 should be used inmost cases, however Modifier59 is a better choice in somesituations If the same test is performed atthe same time with more thanone method/specimen, the 2nd,etc. tests are shown withModifier 59 44AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved22
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsPolling Question #5Patient has three separate woundcultures (CPT 87070) initiated on thesame day. Each culture is from threedifferent anatomical sites. How wouldthe three cultures be reported?*1*2*3*487070 x 387070 x 1, 87070-59 x 287070 x 1, 87070-91 x 287070-59 x 1, 87070-91 x 245Modifiers 76 and 77 Procedure or service repeated ina separate session on the sameday by same physician another physician (Modifier 76)(Modifier 77)May be reported for servicesordered by a physician butperformed by a technician46AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved23
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifiers 76 and 77 The same procedure must bedone in a separate session on thesame day The procedures are reported ontwo lines, the second withModifier 76 or 7747Modifiers LT and RTIdentify procedures, which canbe performed on paired organs Used when a procedure isperformed on only one side 48AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved24
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 50Bilateral procedures performed atthe same operative session Only for paired organs and bodyparts Do not use with procedures whenthe narrative descriptionindicates “unilateral or bilateral”,“bilateral”, or multipleoccurrences 49Modifier 50Do not use LT and RT, when 50applies Units of service when modifier isappended remains as 1 50AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved25
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 50Patient presents to the radiologysuite for a series of radiologicalexams. The patient was in an MVAand did not receive immediatetreatment. He is complaining ofpain in his knees and ankles,bilaterally. The physician hasordered standing bilateral kneefilms, and bilateral ankle views –two views.51Modifier 50 73565 73600-50Bilateral kneesstandingAnkle two views, donebilaterally52AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved26
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifiers - Anatomical SitesAdd specificity to the procedures Modifiers for fingers and toesoverride Modifier 50 EyelidsFingersToesArteriesE1-E4F1-F9TA-T9LC, LD, RC53Modifiers - Anatomical SitesDo not use LT/RT if a morespecific modifier is available Applied to surgical codes andother diagnostic services (9028199569) Artery modifiers are required byCMS for coronary stent placement 92980-92982, 92995, 9299654AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved27
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier GGPerformance of a screeningmammogram and diagnosticmammogram on the same patienton the same day, separateencounters Report both CPT codes for thescreening and diagnosticmammogram Append Modifier GG to thediagnostic mammogram 55Modifier GGPatient comes in for her annualscreening bilateral mammogram.After the images are taken sheleaves the facility. The radiologistreviews the films and ordersadditional digital views. Thepatient is able to return to thefacility the same day.56AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved28
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier GG76091Bilateral mammography G0204-GG Diagnostic mammographyproducing direct digitalimage, bilateral, all views 57Modifier GHDiagnostic mammogramconverted from screeningmammogram on same day, sameencounter The screening mammogram isused as a diagnostic exam basedon findings, additional views arenot needed 58AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved29
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier GHReport the diagnosticmammogram CPT only Append Modifier GH to thediagnostic mammogram CPT 59Modifier GHPatient comes in for a bilateralscreening mammogram. Later, itis determined that this examshould be considered diagnostic. 76091-GH Bilateralmammography 60AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved30
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier TSFollow-up service for diabetesscreening where the beneficiarymeets the definition of prediabetes The modifier indicates thepatient’s eligibility for diabetesscreening services 61Modifier TSAppend modifier to glucosescreening tests (82947, 82950,82951) Coverage and diagnosis codingrequirements also apply s/SE0660.pdf 62AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved31
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier CA Procedure payable only in theinpatient setting when performedemergently on an outpatient whodies prior to admission Applied to any service that isdesignated with a statusindicator “C” indicating that it isan inpatient only service63Modifier CA must be the patient is outpatient; the patient has an emergent,life-threatening condition; a procedure on the inpatient-onlylist is performed on an emergencybasis (either ER or OR) toresuscitate or stabilize the patient;AND the patient dies without beingadmitted as an inpatient64AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved32
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier GA Waiver of liability on file Bill services as covered Patient financially liable65Modifier GY Item or service statutorilyexcluded or does not meet thedefinition of any Medicare benefit Bill services as non-covered ABN is not required Patient financially liable66AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved33
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier GZ Item or service expected to bedenied as not reasonable andnecessary (No signed ABN) Bill services as non-covered Facility is financially responsible67Modifier GN Services delivered under anoutpatient speech-languagepathology plan of care CPT/HCPCS codes billed underrevenue code 44X68AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved34
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier GO Services delivered under anoutpatient occupational therapyplan of care CPT/HCPCS codes billed underrevenue code 43X69Modifier GP Services delivered under anoutpatient physical therapy planof care CPT/HCPCS codes billed underrevenue code 42X70AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved35
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifiers GN, GO, GP Commonly hard-coded in thefacility Chargemaster Required for services provided toMedicare beneficiaries71Modifier Q0 Investigational clinical serviceprovided in a clinical researchstudy that is in an approvedclinical research study Items and services that are beinginvestigated as an objective withinthe study Replaces QA and QR72AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved36
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier Q1 Routine clinical service providedin a clinical research study that isin an approved clinical researchstudy Items and services that are coveredfor Medicare beneficiaries outside ofthe clinical research study Replaces QV73Modifier 58Staged or related procedure orservice by the same physicianduring postoperative period Not used to indicate treatment ofa problem requiring return tooperating room 74AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved37
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 58 Indicates the procedure was Planned at time of originalprocedure More extensive than originalprocedure For therapy following a diagnosticsurgical procedure75Modifier 78Return to the operating room fora related procedure during thepostoperative period of initialprocedure Subsequent procedure is relatedto initial procedure 76AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Reserved38
Reporting Hospital Outpatient ModifiersNotes/Comments/QuestionsModifier 78Subsequent procedure requiresuse of operating room Used when complications arise,not a staged procedure Assign Modifier 78 to thesubsequent procedure 77Modifier 79Unrelated procedure or serviceby the same physician duringthe postoperative period Assign Modifier 79 to thesubsequent procedure 78AHIMA 2008 Audio Seminar SeriesCPT Codes Copyright 2007 by AMA. All Rights Re
OPPS status indicator "V" (clinic or emergency department visit) Modifier is appended to second or subsequent E/M Condition code is required if E/M is in same revenue center on same day Regulatory scrutiny 15 E/M Modifiers - Modifier 27 An established patient is seen in the Wound Care Clinic in the morning for evaluation of .
