Optometry Coding & Billing Alert

Published on Tue Aug 12, 2008 PDF

Question: When I append multiple modifiers to a CPT code, is there any rule about the order in which they should appear?

Pennsylvania Subscriber

Answer: If you are reporting a code that is bundled into another procedure by the Correct Coding Initiative (CCI), you should first list any modifiers that justify reporting the two procedures together -- modifiers like 59 (Distinct procedural service) that show that the procedure was necessary, distinct and separate from the other service.

Next: List any modifiers that affect payment -- such as 50 (Bilateral procedure) or 51 (Multiple procedures).

Then: List any "informational" modifiers -- such as RT or LT -- that will not affect the reimbursement for the CPT code but provide more specific information, such as what side the optometrist performed the procedure on.

Listing informational modifiers before payment modifiers may lead to denials.

-- Answers to You Be the Expert, Reader Questions and Build a Better Business reviewed by David Gibson, OD, FAAO, practicing optometrist in Lubbock, Texas.