Wiki Use of modifier with unlisted CPT code

[tnapora]

For the life of me I cannot find this, but I thought I read somewhere that you cannot use a modifier on an unlisted CPT code. Can somebody validate this for me, or let me know if I am delusional. Thanks

 

[cmelizondo]

modifiers and unlisted procedure codes

I read that just recently too. But I cannot find it either. Maybe it was the encoder that gave me the edit note. But I don't use a modifier with the unlisted codes.

 

[thompsonsyl]

Hi,
I've read the same thing & also covered it in my prep course before taking my test. I also did find it in "writing" on an old Medicare Webinar Q&A page, here's the link:

http://www.medicarenhic.com/cal_prov/seminars/billingbundle_cawebinar_0306.htm

 

[kevbshields]

CPT Assistant made note a couple years ago that modifiers applied to unlisted CPT is inappropriate.

 

[efrohna]

A global period indicator of "YYY" describes carrier priced codes (often unlisted codes) and the allowance determination will take into account all aspects of the procedure performed. A 22 modifier would be inappropriate on an unlisted code, that I know for sure. Hope it helps.
E. Frohna

 

[karansinghchauhan]

Hi, Please note that Bilateral modifier indicator provided by CMS shows that "150% bilateral payment adjustment applies", which means you can use modifers 50, LT, RT with unlisted CPT against which it is mentioned as "150% bilateral payment adjustment applies" Ex-54699. I confirmed this from Supercoder site. THANKS.