Got Multiple Modifiers? How To Sequence Them on the Claim
Posted on 28. Aug, 2009 by Editor in Toolkit
Coders like to say that modifiers help them tell the story of what happened in the operating room, hospital, or doctor’s office. But what if the story you have to tell is very long and complicated?
Bookmark these 4 modifier ordering tips from Becki Geraud, CPC, CEMC, RCC, who presented at the Otolaryngology Specialty Coding Conference in Orlando this past summer.
1. Only one modifier? Append directly after the CPT code it relates to.
2. Got two modifiers? If one is a pricing modifier (example: 26), it goes first. If the other is a statistical modifier (example: 76), put it in the second position.
3. Special note: If you have more than one statistical or informational modifier, it doesn’t matter how you order them.
4. More than 4 modifiers? Append 99 after the CPT code and use Box 19 on the CMS 1500 form to list the modifiers in the correct ranking order, and to indicate which CPT code they are to.
Everything you wanted to know about coding, but were afraid to ask. Coming to a city near you!
If you've already signed in and are still seeing this screen, click here to refresh the page.
- Free updates on CPT, ICD-9, HCPCS, Medicare, NCCI edits, and ICD-10.
- Discounts on 3rd party offers
Loading ...