Modifier KL (2021)

Preoperative Management Only: When one physician performed the preoperative care and evaluation and another physician performed the surgical procedure, the preoperative component may be identified by adding the 56 modifier to the usual procedure number. Use with surgical codes only to indicate that only the pre-operative care was performed. Do not submit 56 modifier on…

Medicare HCPCS modifier PD will be available to wholly owned or wholly operated entities beginning January 1, 2012 and may be appended to Part B claims lines to identify preadmission services that are subject to the 3-day window policy. Full Description: Modifier PD – Diagnostic or related nondiagnostic item or service provided in a wholly…

If a provider or supplier expects that the service or item furnished to the beneficiary may be considered unreasonable and/or medically unnecessary by Medicare, an advanced beneficiary notice (ABN) may be used to inform the beneficiary of his or her financial liability, appeal rights, and protections under the fee-for-service (FFS) Medicare program. Providers and suppliers…

Modifier 59 is used for Distinct Procedural Services. Multiple services provided to a patient on one day by the same provider may appear to be incorrectly coded, when in fact the services may have been performed as reported. Because these circumstances cannot be easily identified modifier 59 was established to permit claims of such a…

For each nonpayable functional G-code, one of the modifiers listed below must be used to report the severity/complexity for that functional limitation: CH Modifier 0 percent impaired, limited or restricted CI Modifier At least 1 percent but less than 20 percent impaired, limited or restricted CJ Modifier At least 20 percent but less than 40…