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E0791 MODIFIER

SuperCoder Posted Tue 19th of July, 2011 19:27:23 PM

Does E0791, in office infusion, need a modifier? For instance if a chemo drug is givin in office with an infusion stationary pump, can the use of the pump be billed and if so does it need a modifier and what modifier if one is needed?

SuperCoder Answered Wed 20th of July, 2011 06:02:59 AM

List of applicable modifiers:-
EY – No physician or other health care provider order for this item or service
GA – Waiver of liability statement issued as required by payer policy, individual case
GY - Item or service statutorily excluded or does not meet the definition of any Medicare benefit
GZ – Item or service expected to be denied as not reasonable and necessary
JB - Administered subcutaneously
KX - Requirements specified in the medical policy have been met

check if you have taken care of usage of appropriate modifiers from the following link:
https://www.noridianmedicare.com/dme/coverage/docs/lcds/current_lcds/external_infusion_pumps.htm%3f

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