Modifiers Approved List modif appWord文件下载.docx
- 文档编号:17183838
- 上传时间:2022-11-28
- 格式:DOCX
- 页数:25
- 大小:23.57KB
Modifiers Approved List modif appWord文件下载.docx
《Modifiers Approved List modif appWord文件下载.docx》由会员分享,可在线阅读,更多相关《Modifiers Approved List modif appWord文件下载.docx(25页珍藏版)》请在冰豆网上搜索。
onthatclaimline.
ApprovedModifier
NationalModifierDescription
Program-SpecificUseoftheModifierandSpecialConsiderations
8A
CFTR(cysticfibrosis)
Thismodifierisonlyusedforprenatalscreeningofcysticfibrosis.
22*
Increasedproceduralservices
Maybeusedwithcomputedtomography(CT)codeswhenadditionalslicesarerequiredoramoredetailedevaluationisnecessary.
UsedbyLocalEducationalAgency(LEA)todenoteanadditional15-minuteserviceincrementrenderedbeyondtherequiredinitialservicetime.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.
Surgical:
Maybebilledwhenproceduresinvolvesignificantlyincreasedoperativecomplexityand/ortimeinasignificantlyalteredsurgicalfieldresultingfromtheeffectsofpriorsurgery,markedscarring,adhesions,inflammation,ordistortedanatomy,irradiation,infection,verylowweight(forexample,neonatesandsmallinfantslessthan10kg)and/ortrauma(asdocumentedinarecipient’smedicalrecord).Justificationisrequiredontheclaim.
24*
UnrelatedE&
Mservicebythesamephysicianduringapostoperativeperiod
25*
NCCIassociated
Significant,separatelyidentifiableE&
Mservicebythesamephysicianonthesamedayoftheprocedureorotherservice
26*
Professionalcomponent
27*
47*
Anesthesiabysurgeon
Donotuseasamodifierforanesthesiacodes.
50*
Bilateralprocedure
51*
Multipleprocedures
52*
Reducedservices
Forusewithsurgerycodes
66820–66821,66830,66840,66850,66920,66930,66940and66982–66985.Requires“ByReport”documentation.
UsedbyLEAtodenoteanannualre-assessment.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.LEAdoesnotrequire“ByReport”documentation.
53*
Discontinuedprocedure
Requires“ByReport”documentation.
54*
Surgicalcareonly
Useonlywithsurgerycodes
55*
Postoperativemanagementonly
58*
Stagedorrelatedprocedureorservicebythesamephysicianduringthepostoperativeperiod
Maybeusedwithcodes15002–15431and52601toaddresssubsequentpart(s)ofastagedprocedure.
59*
Distinctproceduralservice
Usedprimarilywithcodes36818–36819and76816.Alsousedwithothercodes,asappropriate,forNCCIpurposes.
62*
Twosurgeons
66*
Surgicalteam
73
Discontinuedoutpatienthospital/ambulatorysurgerycenter(ASC)procedurepriortotheadministrationofanesthesia(tobereportedbyhospitaloutpatientdepartmentorsurgicalclinic,only)
Tobereportedbyhospitaloutpatientdepartmentorsurgicalcliniconly.Requires“ByReport”documentation.
74
Discontinuedoutpatienthospital/ambulatorysurgerycenter(ASC)procedureafteradministrationofanesthesia
76*
Repeatprocedureorservicebysamephysician
77*
Repeatprocedurebyanotherphysician
78*
Unplannedreturntotheoperating/procedureroombythesamephysicianfollowinginitialprocedureforarelatedprocedureduringthepostoperativeperiod
79*
Unrelatedprocedureorservicebythesamephysicianduringthepostoperativeperiod
80*
Assistantsurgeon
90*
Reference(outside)laboratory
Onlyspecifiedprovidersmayusethismodifier.
91*
Repeatclinicaldiagnosticlaboratorytest
99*
Multiplemodifiers
Usedwhentwoormoremodifiersarenecessarytocompletelydelineateaservice;
themultiplemodifiersusedmustbeexplainedintheRemarksfield(Box80)/ReservedforLocalUsefield(Box19)oftheclaim.
AlsousedinspecialcircumstancesasspecifiedbytheDepartmentofHealthCareServices(DHCS).Foranexample,refertotheSurgeryBillingExamples:
UB-04orSurgeryBillingExamples:
CMS-1500sectionsintheappropriatePart2manual.
AG
Primaryphysician
Usedtodenoteaprimarysurgeon.Inthecaseofmultipleprimarysurgeons,twoormoresurgeonscanusemodifierAGforthesamepatientonthesamedateofserviceiftheproceduresareperformedindependentlyandindifferentspecialtyareas.
Thisdoesnotincludesurgicalteamsorsurgeonsperformingasingleprocedurerequiringdifferentskills.Anexplanationoftheclinicalsituationandoperativereportsbyallsurgeonsinvolvedmustbeincludedwiththeclaim.
UsedbyLEAtodenotelicensedphysicians/psychiatrists.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.
AH
Clinicalpsychologist
UsedbyLEAtodenotelicensedpsychologists,licensededucationalpsychologistsandcredentialedschoolpsychologists.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.
AI
Principalphysicianofrecord
Allowableforallprocedurecodes.
AJ
Clinicalsocialworker
UsedbyLEAtodenotelicensedclinicalsocialworkersandcredentialedschoolsocialworkers.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.
AP
Determinationofrefractivestatewasnotperformedinthecourseofdiagnosticophthalmologicalexamination
Useonlyforophthalmology.
E1
Upperleft,eyelid
UsemodifierSCwithCPT-4code68761(closureoflacrimalpunctum;
bythermocauterization,ligation,orlasersurgery;
byplug,each)toindicateuseoftemporarycollagenpunctalplugs.ModifiersE1thruE4areusedinconnectionwithpermanentsiliconepunctalplugsandproceduresontheeyelids.
E2
Lowerleft,eyelid
Sameasabove
E3
Upperright,eyelid
E4
Lowerright,eyelid
ET
Emergencyservices
F1
Lefthand,seconddigit
F2
Lefthand,thirddigit
F3
Lefthand,fourthdigit
F4
Lefthand,fifthdigit
F5
Righthand,thumb
F6
Righthand,seconddigit
F7
Righthand,thirddigit
F8
Righthand,fourthdigit
F9
Righthand,fifthdigit
FA
Lefthand,thumb
GN
Servicedeliveredunderanoutpatientspeech-languagepathologyplanofcare
UsedbyLEAtodenotelicensedspeech-languagepathologistsandspeech-languagepathologists.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.
GO
Servicedeliveredunderanoutpatientoccupationaltherapyplanofcare
UsedbyLEAtodenoteregisteredoccupationaltherapists.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.
GP
Servicedeliveredunderanoutpatientphysicaltherapyplanofcare
UsedbyLEAtodenotelicensedphysicaltherapists.SeeLocalEducationalAgency(LEA)intheappropriatePart2manualformoreinformation.
GQ
Viaasynchronoustelecommunicationssystem
Usedtodenotestore-and-forwardtelecommunicationssystem.
GT
Viainteractiveaudioandvideotelecommunicationssystems
Usedtodenotereal-timetelecommunicationssystem.
GY
Itemorservicestatutorilyexcluded;
doesnotmeetthedefinitionofanyMedicarebenefitor
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- Modifiers Approved List modif app
![提示](https://static.bdocx.com/images/bang_tan.gif)