ESRD claims for hemodialysis must indicate the type of vascular access used for the delivery of the hemodialysis at the last hemodialysis session of the month. One of the following codes is required to be reported on the latest line item date of service billing for hemodialysis revenue code 0821. It may be reported on…

All hemodialysis claims must indicate the dialysis patient’s most recent Urea Reduction Ratio (URR). Code all claims using CPT 90999 and the appropriate G modifier listed below. List With G Modifiers Urea Reduction Ratio (URR) Modifiers. G1 Modifier Description of Modifier G1: Most recent URR of less than 60%. G2 Modifier Description of Modifier G2:…

CMS uses modifier EA, Modifier EB and Modifier EC to gather information to determine the prevalence and severity of anemia associated with cancer therapy, the clinical and hematologic responses to the institution of antianemia therapy, and the outcomes associated with various doses of antianemia therapy. Modifier EA What is Modifier EA? Erythropoetic stimulating agent (ESA)…

QW Modifier applies to the services when the Physician performs CLIA waived test. This article covers a complete description of Modifier QW and when to use it. QW Modifier Description QW Modifier appends with Physician performs CLIA-waived (Clinical Laboratory Improvement Amendments) test.   Laboratory procedure testing is regulated through CLIA by the Centers for Medicare &…

The Hospice Modifiers (Modifier GV & Modifier GW) can be used when patients are enrolled in hospice and if they are expected to pass away within the next 6 months. A hospice modifier is required to indicate that a separate payment should be allowed when a physician treats a patient in hospice. The hospice does…

The GA Modifier is applied for service when a waiver of liability statement is issued as required by payer policy, individual case. We will explain what modifier GA is and how you can use it. Summary & Description The official description of modifier GA is: “Waiver of liability statement issued as required by payer policy,…

Modifier XE, Modifier XS, Modifier XP & Modifier XU are created for billing certain codes at high risk for incorrect billing even though it still recognizes modifier 59. Descriptions and examples of Modifier XE, Modifier XS, Modifier XP & Modifier XU can be found below. The Current Procedural Terminology (CPT) instructions state that modifier 59…

Ambulance transportation is a covered service when the patient’s condition is such that the use of any other method of transportation would endanger the patient’s health. CPT Codes For Ambulance Transport There are CPT codes for ground ambulance services that refers to both land and water transportation and selection of codes would be based on…

HCPCS introduced severity modifiers to identify the functional impairment of a patient. Below we explain what the severity modifiers are and how to use them.  1. What Are The Severity Modifiers? Severity modifiers show a patient’s functional impairment with a percentage. The functional impairment of a patient is determined by a; A severity modifier shows…

Report HCPCS modifier FY to a radiology code to indicate that a digital image was created using cassette-based imaging, such as a phosphor imaging plate (IP), rather than conventional film. 1. What Is Modifier FY? Providers are required to append HCPCS modifier FY to a radiology code when the imaging involves cassette-based imaging. Medicare payments…