Pediatric Coding Alert

Avoiding modifiers because you don't know the rules could cause you to leave cash on the table. When it comes to appending CPT® modifiers to your codes, the rules can be daunting, and insurers' regulationsonly compound the confusion. But if you're up to speed on these key modifier billing practices, you'll be raking in deserved pay. Figure out how you would answer the following five questions submitted to Pediatric Coding Alert to determine whether you're missing any opportunities. Know When Modifier 26 Applies We commonly report radiology codes for services such as chest x-rays without a modifier when the pediatrician only performs the interpretation. In the past we have received appropriate reimbursement for only the professional component because the carrier paid the hospital that performed the x-ray for the technical component. Lately, however, we have received some full payments on these claims, even though we only deserve professional-component pay. What's [...]