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 use the 93 modifier?
Modifier 93 should be used when a healthcare service uses audio-only technology, such as a telephone call. This may occur when the patient cannot use, does not wish to use, or does not have access to two-way audio/video technology. In addition, the patient is typically at a distant site from the provider.
It is essential to check with individual payers for their specific policies, guidelines, and codes for which the modifier 93 assignment is applicable. For example, some payers may require using another modifier or a specific place of service code instead.
The official description of modifier 93 is: “synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system.”
Examples of procedures that may require modifier 93 include telephone consultations, remote monitoring of a patient’s condition, and counseling sessions provided via audio-only technology.
When using modifier 93, it is important to document the extent and nature of the communication during the telemedicine service. This documentation should meet the key components or requirements of the same service performed face-to-face.
To bill for a healthcare service using modifier 93, append the modifier to the appropriate CPT code. Check with individual payers for their specific policies and guidelines for billing with modifier 93.
7. Common mistakes
Medical coders make common mistakes when using modifier 93, including failing to document the extent and nature of the communication during the telemedicine service and checking with individual payers for their specific policies and guidelines for billing with modifier 93.
To avoid these mistakes, staying up-to-date with the latest coding guidelines and double-checking all documentation and billing codes before submitting claims is important.
8. Other modifiers related to modifier 93
Other modifiers related to modifier 93 include modifier 95, which indicates a synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system, and modifier G2012, which indicates a fast communication technology-based service, such as a virtual check-in.
When using modifier 93, it is important to ensure that the audio-only technology is secure and HIPAA-compliant.
It is also essential to provide clear instructions to patients on how to use the technology and to have a backup plan in case of technical difficulties.