Modifier 32 should be used when services related to mandated consultation and/or related services such as confirmatory consultations and related diagnostic services (e.g. third-party payer, governmental, legislative, or regulatory requirement) may be identified by adding modifier 32 to the primary procedure. The official description of Modifier 32 is: “Mandated Services”. Billing Guidelines For Modifier 32…

Bilateral services are procedures performed on both sides of the body during the same operative session or on the same day. Modifier 50 is not applicable to procedures that are bilateral by definition or their descriptions include the terminology “bilateral” or “unilateral”. For example: CPT 69210 Removal impacted cerumen in one or both ears. The…

Modifier 96 appends with the services when the physician performs Habilitative services. Read on to find out more about what modifier 96 is and when to use it. Description Of The Modifier 96 Modifier 96 indicates the services when the physician or other skilled or qualified professional offers habilitative and rehabilitative procedures or services for…

The 23 modifier can be reported for unusual anesthesia. The description, billing guidelines, and reimbursement for this modifier are below. Description Of Modifier 23 The 23 modifier can be used for unusual Anesthesia. The official description of modifier 23 is: “Unusual Anesthesia.” Occasionally, a procedure requiring either no anesthesia or local anesthesia because of unusual circumstances…

Modifier 21 was deleted in 2009. This was because many payers didn’t recognize the 21 modifier. Instead, report CPT 99354 to CPT 99359 for prolonged services. Description Modifier 21 was used when the face-to-face service was prolonged or otherwise greater than normal. And only if the services were of the highest level of E&M within…

The two modifiers, modifier 96 and the 97 modifier, were created to identify services as habilitative or rehabilitative, as follows: Modifier 96 Habilitative Services: When a service or procedure that may either be habilitative in nature or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified healthcare professional may add modifier 96-…

The 52 modifier can be used for reduced services. We explain in this article how to use this modifier. Description Of Modifier 52 Modifier 52 identifies situations where the physician elects to reduce or eliminate a portion of a service or procedure. The official description of the 52 modifier is: “Reduced Services.“ Cover letters or operative…

Modifier 25 applies when the physician performs a significantly different or Separately Identifiable Evaluation and Management procedure by the Same Physician or Other skilled Professional on the exact procedure date or Other Service. Description Of Modifier 25 Modifier 25 can be used when the physician performs a significantly different or separately identifiable evaluation and management…

Modifier 24 appends with the service when the physician performs unrelated Evaluation and Management services during the postoperative period. Description Of The 24 Modifier Modifier 24 attaches to the service when the physician renders the service in the postoperative period for unrelated Evaluation and management services. Therefore, adding 24 with surgical procedure codes 10000-6000 is…

Are you looking for billing guidelines for the 54 modifier for surgical care only? Underneath the description, coding guidelines, and reimbursement for this modifier. Description Of The 54 Modifier Modifier 54 identifies when one physician performs a surgical procedure, and another provides preoperative and/or postoperative management. The surgeon who performs the surgical procedure reports the…