The description of modifier 55, the coding guidelines, billing requirements and reimbursement can be found below. Description Of The 55 Modifier The official description of modifier 55 is: “Postoperative Management Only.” How To Use Modifier 55 Billing Requirements Modifier 55 is used to identify postoperative, out-of-hospital medical care associated with a given surgical procedure. When…
Modifier 58 is described in the CPT Manual as follows: “staged or related procedure or service by the same physician during the postoperative period”. Usage Of The 58 Modifier The 58 modifier may be used to indicate that a procedure was followed by a second procedure during the postoperative period of the first procedure. This…
Modifier 26 identifies the physician’s or professional component of a two-component (professional and technical) service. The physician component is reported separately when the physician provides only the supervision and interpretation portion of the procedure. The technical component includes reimbursement for the facility, equipment, film processing, and the technician. Modifier 26: Appropriate Usage To bill for…
Modifier 99 indicates multiple modifiers associated with a procedure or service. 1. What is modifier 99? Modifier 99 describes a situation where two or more additional modifiers apply to a service or procedure, but there is not enough space to list them all. In such cases, modifier 99 is the first modifier to the procedure…
Modifier 97 describes rehabilitative services that are provided to help restore or improve a patient’s skill or function that was lost due to injury or disease. 1. What is modifier 97? Modifier 97 is a CPT modifier used to indicate that rehabilitative services were provided to help a patient regain or improve a skill or…
Modifier 95 indicates a synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system. 1. What is modifier 95? Modifier 95 is a telehealth modifier that identifies services provided through a synchronous or real-time audiovisual conference between a patient and a provider. In this scenario, the provider at a distant site provides…
Modifier 93 describes a synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system. 1. What is modifier 93? Modifier 93 is used to indicate a healthcare service that was provided using audio-only communication technology. This technology allows for real-time interaction between the provider and patient without video visualization. 2. When to…
Modifier 92 describes alternative laboratory platform testing. In this article, we will explain modifier 92, its appropriate usage, documentation requirements, billing procedures, common mistakes, related modifiers, and additional tips for medical coders. 1. What is Modifier 92? Modifier 92 is a modifier used to indicate the use of an alternative laboratory platform test. This test…
Modifier 91 indicates a repeat lab test on the same day for the same patient. 1. What is modifier 91? Modifier 91 describes a repeat clinical diagnostic laboratory test d on the same patienton the same day to obtain subsequent or multiple test results. This modifier indicates that the second test was not a duplicate…
Modifier 90 describes a reference (outside) laboratory and indicates that an outside lab performed a laboratory or pathology test instead of the treating or reporting provider. 1. What is modifier 90? Modifier 90 is a billing modifier that indicates that an outside lab performed a laboratory or pathology test instead of the treating or reporting…
