General Surgery Coding Alert

Question: I’ve heard we are supposed to be using modifier CR on COVID-19 related claims. Could you explain what it is and how we should use it?

Tennessee Subscriber

Answer: Modifier CR (Catastrophe/disaster related) is required for applicable CPT^®/HCPCS Level II codes (except telehealth) on Medicare Part B claims involving services covered during the COVID-19 public health emergency (PHE) based on a “formal waiver.”

For instance, under section 1135 of the Social Security Act, Medicare may temporarily “waive” or modify certain Medicare requirements to ensure that sufficient healthcare items and services are available to meet the needs of beneficiaries. You can see a complete list of those waivers at www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf.

Some examples that might impact your surgery practice include the following:

• Claims for testing services at newly set up swab sites.
• Telephone calls (98966‒98968; 99441‒99443). Note that these are not telehealth services.
• Providers rendering services in states in which they are not licensed.
• Services by a teaching physician supervised virtually under the waiver for an in-person supervision.

CMS initially created modifier CR in 2005 to assist in processing claims related to Hurricane Katrina, but the agency also authorized the modifier for use on Part B claims for any services affected as a result of future emergencies.