Orthopedic Coding Alert

Question: What modifier changes should orthopedic practices know about for 2011?

Answer: This year it is important to know about a few new modifiers, as well as some revisions to existing CPT modifiers.

2011 adds several new modifiers to your coding arsenal and updates the descriptors for several others you might often use. For example, you can use modifier GU (Waiver of liability statement issued as required by payer policy, routine notice) for dates of service Jan. 1, 2011 and thereafter.

You might have times when it's appropriate to report modifier GU instead of the revised standby modifier GA (Waiver of liability statement on file; individual).

Plus: Three existing CPT modifiers now include nonphysician providers in the descriptors, as follows:

• Modifier 76 -- Repeat procedure or service by same physician or non-physician provider
• Modifier 77 -- Repeat procedure or service by another physician or non-physician provider
• Modifier 78 -- Unplanned return to the operating/procedure room by the same physician or nonphysician provider following initial procedure for a related procedure during the postoperative period).

In previous years, some payers didn't allow nonphysician providers to report their services with these modifiers since they specifically addressed "physician" care. Updating the descriptors should make it easier for you to report situations represented by modifiers 76, 77, or 78 to your payers.