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Thread: Modifier 52

  1. #1

    Default Modifier 52

    AAPC: Back to School
    Recently a billing office for a Neurology Practice asked about the use of Modifier 52 specifically as it relates to billing code 95974 (Electronic Analysis of Implanted Neurostimulator, First Hour.) This is a time based code for the first hour of testing. Does Modifier 52 have to be appended if the dosing time falls short of 30 minutes even though the procedure was completed in its entirety? Your response is greatly appreciated.

  2. #2
    Join Date
    Apr 2007
    San Antonio, Tx


    The procedure states that this is for the first hour. Does not mean that it MUST last for the entire hour. 95975 is for each additional 30 minutes beyond the first hour. So if the procedures lasts for 1hr and 10 minutes, for example, then you would bill 95974 and 95975. Hope this clears it up!
    Ray Galvez CPC

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