The Q0 (Q-Zero) modifier should only be applied if it is a primary prevention implant - this should be about 95% of the defibrillators you report. Patients typically have an associated diagnosis that is heart failure, old myocardial infarction, and/or non-ischemic dilated cardiomyopathy. You should not use the Q0 modifier if it is a secondary prevention implant - these patients will have a diagnosis that indicates they have had ventricular fibrillation, sustained ventricular tachycardia, or sudden cardiac death. While the national coverage policy doesn't specify this, I have found that the modifier must be used with an associated primary prevention indication - it essentially directs the claim processing system to look for one of the primary prevention indications.
Jim Collins, CPC, CCC
President, CardiologyBiller.Com