With so many separate procedure modifiers, coders may become confused as to which one to use with their procedure codes. This resource form, which focuses on -XS (separate structure) and -XU (unusual non-overlapping service), may be used to clarify when these modifiers are appropriate to append.
Coding professionals who work in ASC may be familiar with anesthesia modifiers -73 (discontinued outpatient hospital/ambulatory surgery center [ASC] procedure prior to the administration of anesthesia) and -74 (discontinued outpatient hospital/ambulatory surgery center [ASC] procedure after administration of anesthesia). This resource form clarifies instances when these modifiers are appropriate to append.
Modifiers -GX (notice of liability issued, voluntary under payer policy) and -GY (Item or service statutorily excluded, does not meet the definition of any Medicare benefit or, for non-Medicare insurers, is not a contract benefit) tend to cause confusion for many coding professionals. This resource form may be used to clarify when these modifiers are appropriate to append.
Modifier -25 indicates a "significant, separately identifiable E/M service." Incorporate the tips below and click the "Download file" link above to access a modifier -25 decision tree.
The following decision tree addresses the mistakes that auditors for Medicare administrative contractors (MAC) and investigators are finding. Share it with providers and billing staff to help them recognize when they can — and cannot — bill a visit incident-to a physician.
PREOPERATIVE DIAGNOSIS: Acute lymphocytic leukemia in remission.
POSTOPERATIVE DIAGNOSIS: Acute lymphocytic leukemia in remission.
OPERATION PERFORMED: Removal of tunneled venous port.
ANESTHESIA: General.
INDICATIONS: This 19-year-old patient presented with ALL and had a tunneled venous access port placed at that time. Patient has subsequently undergone chemotherapy and is now off therapy, and no longer needs a venous port.
Clinical documentation, Hospital outpatient, Physician practice
Please note that CEUs for this webinar are no longer available.
Outpatient documentation and coding for behavioral health and psychiatry brings a set of unique challenges. Join expert Laurie Bouzarelos, MHA, CPC, for this 90-minute webinar, during which she will provide an in-depth review of documentation and ICD-10-CM/CPT coding for behavioral health and psychiatry.
