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Thread: multiple modifiers

  1. #11

    Default

    Promo: Code Books
    When using the -Q6 mod and -25 which one should come first?

  2. #12

    Default Busy Coder

    Does anyone know why Medicare isnt paying stents and caths done during the same encounter? I always apply modifier 26/59, but its not paying.

    thanks...BXN

  3. #13
    Join Date
    Apr 2007
    Location
    Everett, WA
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    Default

    This topic of multiple modifiers brings up another thought. When more than two modifiers are needed, how appropriate is it to use modifier 99? From what I've studied this modifier may be a carrier preference and halts the processing of the claim and reverts to manual review. And if so, how would it's application be beneficial to the questions submitted on this thread? ---Suzanne E. Byrum CPC

  4. #14
    Join Date
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    Default 99 w/ multiple modifiers

    Quote Originally Posted by ollielooya View Post
    When more than two modifiers are needed, how appropriate is it to use modifier 99?
    As I recall, you only use 99 when there are more than 4 modifiers on a procedure. The CMS-1500 procedure line has spaces for 4 modifiers but when there are more you enter 99 on your first line and then add additional lines to pick up all the appropriate modifiers.
    Last edited by RonMcK3; 01-09-2012 at 08:18 PM. Reason: add quoted text
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  5. #15
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    Default

    Hi, Ron, and thanks for your input, but I do not ever remember being instructed that more than 4 modifiers would require the use of 99 and I found this in Ingenix 2010 Understanding Modifiers. It suggests that 2 or more modifiers may be necessary to completely delineate a service and that mod. 99 should be added on to the basic procedure, and depending on whether or not the 3rd party computer system accepts multiple modifiers on the same line that it would not be needed. And since there are 4 spaces for modifiers...I suspect you probably were addressing this? I would think additional information could be submitted on line 19 of the HCFA form. Don't know if this spin-off thread should assigned to a "new post", but I find this topic very interesting. ---Suzanne

  6. #16
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    Location
    Greater Orlando
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    Default

    Hi, Suzanne,

    My reference to a max of 4 modifiers probably is specifc to manually submitted CMS-1500 forms, given that the form (block 24) is limited to a max of 6 procedure lines.
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  7. #17

    Default Modifiers 22 & 52

    Is there something that states that modifier 22 and 52 can't be coded on the same code? I code GI and some of the procedures are reduced due to the complexity of the procedure. Just wondering....

  8. #18

    Default How would you report E/M, X-ray & Proc Code

    How would report this? E/M, X-ray and Procedure code 20552 on the same dos? Would this be correct?

    992XX -25 E/M
    70355 Pano
    20552 -51 Trigger point Inj; 1 or 2 muscles
    ----------------------------
    R.Whiting, CPC, CPC-I
    AAPC Approved ICD-10 CM Trainer
    AAPC Licensed PMCC Instructor
    Owner/The Whiting Institute, LLC
    www.thewhitinginstitute.com

  9. #19

    Default

    Hi R. Whiting, You wouldn't have to have the -51 modifier on your procedure. As the x-ray is not subject to multiple procedures.

  10. #20

    Default

    Good morning,

    If you were using a modifier 78 & 59 which modifier would you use first?

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