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Modifier Coding Alert

Multiple Procedures:
Focus on Debridement Types Before Adding 59
Remember, anatomical area is not an issue for these services. When a physician perform... Read more
News You Can Use:
Note New POS to Nail 'Off-Campus' Coding
Anticipate imminent changes in payment for off-campus provider-based clinics. As of Ja... Read more
Catastrophe/Disasters:
Prepare for the Worst with Modifier CR Smarts
President must make declaration before you can use modifier. While no one wants to thi... Read more
You Be the Expert:
Unbundling Codes on Multiple Mammographies
Question: A 68-year-old Medicare patient reports to the physician for a scheduled s... Read more
Reader Question:
Remember Modifier 51 for Payers that Still Require It
Question: Our orthopedic surgeon recently performed the following fracture care rep... Read more
Reader Question:
Consider Payer Preference When Making 52/53 Decision
Question: During an endoscopic retrograde cholangiopancreatography (ERCP) procedure... Read more
Reader Question:
Remember Modifier Pair for ED E/M, Thoracentesis
Question: A patient with shortness of breath reports to the emergency department (E... Read more
Reader Question:
Use 25 with New Prolonged Services Codes to Max Out Payment
Question: A 25-year-old new patient reports to the gastroenterologist complaining o... Read more
FAQ:
Focus on Site of Service, Code Sets to Ensure Modifier 26 Success
Here’s why many modifier 26 encounters occur off-site. When using modifier 26 (P... Read more
Use Separate Services, Not Diagnoses, to Drive E/M-25 Decision
Without E/M components separate from the procedure, you can’t report E/M-25. Whe... Read more
Pathology/Lab Coding:
Get Payer Input Before Reporting 90
Rules for reference lab modifier will vary by payer, region. When your practice codes ... Read more
You Be the Expert:
Choosing Modifiers for Hospice Patients
Question: A patient at a local hospice care facility with terminal lung cancer was havin... Read more
Reader Question:
Keep PC in Your Pocket for Some Surgical Mix-ups
Question: Some of the coders in the office were discussing a news story in which a patie... Read more
Reader Question:
Use These Modifier Tips to Avoid Inappropriate Usage Denials
Question: I have been training several new coders, and a couple of them are having probl... Read more
Reader Question:
Check Coding 'Family' Before Deciding on 59 or 51
Question: A patient reported to our practice for a scheduled esophagogastroduodenos... Read more