Modifiers Jeffrey D Lehrman DPM FASPS MAPWCA APMA
- Slides: 26
Modifiers Jeffrey D. Lehrman, DPM, FASPS, MAPWCA APMA Coding Committee Expert Panelist, Codingline APMA MACRA Task Force Fellow, American Academy of Podiatric Practice Management Board of Directors, ASPS Board of Directors, APWCA Twitter: @Dr. Lehrman
T 2 T 1 T 3 T 4 LT TA
T 5 T 6 RT T 7 T 8 T 9
22 Modifier - Increased Procedural Services Op Report must support the substantial additional work and the reason for the additional work • Increased intensity • Increased time • Technical difficulty of procedure • Severity of patient’s condition • Physical and mental effort required Should not be appended to an E/M service Procedures Only!
22 Modifier • Two documents required to support the claim. 1) An operative report 2) A narrative indicating how the service differs from the usual Legit examples Non-Legit examples
25 Modifier • Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
50 modifier • Bilateral Procedure
50 Modifier • Bilateral Keller
Bilateral Keller CPT 28292 – 50 modifier One unit No Laterality modifiers Bill twice normal
Bilateral 2 nd Metatarsal Condylectomy
Bilateral 2 nd Metatarsal Condylectomy CPT 28288 – RT CPT 28288 – LT – 59 mod
59 modifier Distinct Procedural Service Documentation must support • Different session, • Different procedure or surgery • Different site or organ system • Separate incision or excision • Separate lesion • Separate injury (or area of injury in extensive injuries) • Not ordinarily encountered or performed on the same day by the same individual.
Coding During Global • E/M – 24 modifier • Procedure – 58 modifier – 79 modifier
24 Modifier • Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period
79 modifier • Unrelated Procedure or Service by the Same Physician During the Postoperative Period
78 modifier • Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period
58 modifier • Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
57 modifier • Decision for Surgery
JW / JC Modifiers Effective 1 -1 -2017 Use with CTPs Bill product using 2 lines Units of CTP used: Q code X units – JC mod Units of CTP discarded: Q code X units - JW mod Line 1 + Line 2 = Total CTP product
FX Modifier Payment Reduction For The Technical Component for X-Rays Taken Using Film • Effective 01/01/2017 • Applies to Medicare only
Thank You!!
Modifiers Jeffrey D. Lehrman, DPM, FASPS, MAPWCA APMA Coding Committee Expert Panelist, Codingline APMA MACRA Task Force Fellow, American Academy of Podiatric Practice Management Board of Directors, ASPS Board of Directors, APWCA Twitter: @Dr. Lehrman
Resources • • Kesselman, P. , DPM. (September, 2013). Wound care billing update, Podiatry Management pg 53 -59 Le. Grand, M. , RN, MA CCS-P, CPC. , Changes in reporting wound débridement, http: //www. aaos. org/news/aaosnow/jun 11/managing 2. asp CGS Medicare. (May 9, 2012). Documenting surgical debridement services – Measurements matter. https: //www. cgsmedicare. com/ohb/pubs/news/2012/0512/cope 18819. html, Noridian Medicare, Wound care and debridement – Provided by physician, NPP or as incident-to services, https: //www. noridianmedicare. com/cgibin/coranto/viewnews. cgi? id=EFFZFZyy. Ep. AJGDJCx. K&tmpl=part_a_viewnews&st yle=part_ab_viewnews Fife, C. E. , MD, FAAFP, CWS. The debridement dilemma returns, http: //www. todayswoundclinic. com/debridement-dilemmareturns? page=4, National Government Services LCD for Debridement Services (L 27373), http: //apps. ngsmedicare. com/lcd/LCD_L 27373. htm, Just Coding News. (August 8, 2012). Differentiate between types of wound debridement. Just. Coding News: Outpatient
- Midfoot sprain icd 10
- Uva drop deadline engineering
- Apma journal club
- Cpt 28296
- Difference between dpc and dpm in construction
- Dpm architect
- Nn dpm
- Dpms uksw
- Gradinita step up ploiesti
- Dpm architect
- Alessandro de salvo
- Dpm
- Dpm architect
- Visi misi ketua angkatan fakultas ekonomi
- Fungsi advokasi dpm
- Dpm ppm
- Dpm vmware
- Romanian dpm
- Program kerja ketua umum
- Jeffrey kallen
- Jeffrey ellenbogen
- Jeffrey horstmyer md
- Jeffrey markuns md
- Jeffrey eldred
- Jeffrey snover powershell training
- Dr. jeffrey sklar
- Cisco tacs