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Urology Coding Alert

CPT® 2012:

Look Forward to 'Other Qualified Healthcare Professional' Clarification

Published on Mon Nov 21, 2011

Watch out: The new definition isn't all good news.If you've wondered what "other qualified healthcare professional" means when you see this phrase in a particular code or modifier description, such as for modifier 78 (Unplanned return to the operating/procedure room by the same physician or other qualified healthcare professional following initial procedure for a related procedure during the postoperativ period), CPT® 2012 has the answer.At the request of many physicians, CPT® 2012 now defines this terminology. Here's what you need to know. Don't Miss Errata ClarificationsAlthough this definition didn't make it into the 2012 manual, the AMA lists it as part of the "CPT® 2012 Errata" on its Web site (www.ama-assn.org/resources/doc/cpt/cpt-2011-corrections.pdf) with the definition as follows:"A 'physician or other qualified health care professional' is an individual who by education, training, licensure/regulation, and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports [...]
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