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Wiki Modifier Sequencing

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candicoder

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Local Chapter Officer
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La Plata, MD
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Hi,

Have a question about how to sequence modifiers on a claim. We are billing for a surgeon, and we are being told to always put the "Fee increasing " modifier (ex. 22) as the first modifier, even in front of the assist or co-surgeon modifier.

EX: 63030,62,22 is how we had been submitting the charge and now a billing rep is telling us we have to submit as 63030,22,62.

We have looked high & low and can't find anything definative to support either position. I know that modifier acceptance is of course carrier specific, so we are in a quandry about being told to change how we have been sequencing the modifiers.

Any guidence/help is greatly appreciated.

Candi :eek:
 
Our local Medicare has a modifier reference billing guide (see attached link) http://www.umd.nycpic.com/Guide-Modifier_Reference.pdf I took a look at it and it states mod 22 is a pricing modifier and 62 is a statistical pricing modifier it instructs the order of ranking would be Pricing modifier first (22) then the statistical modifer second (62) Take a look at the above link see what you think.

Melissa Jewett, CPC
 
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