Radiology Coding Alert

Reader Questions:

Leave Modifier 63 Off of Radiology Claims

Question:If we perform an imaging service for an infant, should we append modifier 63?Indiana SubscriberAnswer:No. The guidelines for modifier 63 (Procedure performed on infants less than 4 kg) in CPT's Appendix A state that "unless otherwise designated, this modifier may only be appended to procedures/services listed in the 20000-69999 code series." So you should not append modifier 63 to radiology codes found in the 70000 section.Bonus tip: If you do report a service that modifier 63 is appropriate for, pay attention to the weight requirement of "less than 4kg," which translates to roughly 8.8 pounds or less.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Radiology Coding Alert

View All