54 Modifier – Description, Billing Guidelines & Reimbursement

54 Modifier – Description, Billing Guidelines & Reimbursement

Are you looking for billing guidelines for the 54 modifier? Underneath the description, coding guidelines and reimbursement for this modifier. Description 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 54 modifier. Billing Guidelines Submit the 54 modifier…

X Modifiers List (2022) – Descriptions, Billing Guidelines & Examples

X Modifiers List (2022) – Descriptions, Billing Guidelines & Examples

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…

Modifier 55 (Postoperative Management Only)

Modifier 55 (Postoperative Management Only)

The description of modifier 55, the coding guidelines, billing requirements and reimbursement can be found below. 55 Modifier Description The CPT Manual describes modifier 55 as: “When one physician performed the postoperative management only modifier and another physician performed the surgical procedure, the postoperative component may be identified by adding modifier 55 definition to the…

Modifier 32 – Billing Guidelines

Modifier 32 – Billing Guidelines

Modifier 32 should be used when services related to mandated consultation and / or related services such as confirmatory consultations and related diagnostic service (eg. third party payer, governmental, legislative or regulatory requirement) may be identified by adding modifier 32 to the basic procedure. Billing Guidelines For Modifier 32 The use of modifier 32 is…

(2022) Modifier 27 – Description & Billing Guidelines

(2022) Modifier 27 – Description & Billing Guidelines

The CPT manual describes modifier 27 as “multiple outpatient hospital evaluation and management encounters on the same date.” Usage Of Modifier 27 Use this modifier when a patient receives multiple E/M services performed by the same or different physicians in multiple outpatient hospital settings (e.g., emergency department, clinic, etc.) Application Of Modifier 27 Modifier 27 should be…

(2022) EA Modifier,  EB Modifier & EC Modifier – Descriptions & Guidelines

(2022) EA Modifier, EB Modifier & EC Modifier – Descriptions & Guidelines

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)…

What Is Modifier FY? | Description & Billing Guidelines

What Is Modifier FY? | Description & Billing Guidelines

The FY modifier can be used for X-rays taken with computed radiography technology or cassette-based imaging. Below the description and billing guidelines for this modifier. What Is A FY Modifier? Modifier FY is defined by the CPT manual as: “X-ray taken using computed radiography technology/cassette-based imaging”. Beginning January 1, 2018, and including Calendar Years (CY)…

Modifier X1-X5 (2021)

Modifier X1-X5 (2021)

Beginning Jan. 1, 2018, clinicians may report on Medicare Part B claims submitted for items and services the applicable HCPCS Level II modifiers established for patient relationship categories. Although the use and selection of these modifiers are not be a condition of payment, yet, clinicians should prepare for the likelihood of them becoming applicable components…