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Resource CPT Modifiers

CCO Video Modifiers Made Easy:



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22- Increased Procedural Services
23- Unusual Anesthesia
24- Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
25- Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Service
26- Professional Component
27-Multiple Outpatient Hospital E/M Encounters on the Same Date
32- Mandated Services
33- Preventative Services
47- Anesthesia by Surgeon
50- Bilateral Procedures
51- Multiple Procedures (some multiple surgical procedures must be reported WITHOUT modifier 51 identified as add on codes (appendix I)
52- Reduced Services
53- Discontinued Procedure
54- Surgical Care Only
55- Postoperative Management Only
56- Preoperative Management Only
57- Decision for Surgery
58- Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
59- Distinct Procedural Service
62 -Two Surgeons
63- Procedure Performed on Infants less than 4 kg.
66- Surgical Team
73- Discontinued Outpatient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia
74- Discontinued Outpatient Hospital/Ambulatory Surgery Center (ASC) Procedure After the Administration of Anesthesia
76 -Repeat Procedure by Same Physician or Other Qualified Health Care Professional
77- Repeat Procedure by Another Physician or Other Qualified Health Care Professional
78- Unplanned Return to the Operating Room by Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
79- Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period
80- Assistant Surgeon
81- Minimum Assistant Surgeon
82- Assistant Surgeon (when qualified surgeon no available)
90- Reference (Outside) Laboratory
91- Repeat Clinical Diagnostic Laboratory Test
92-Alternative Laboratory Platform Testing
93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
95- Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunication System
96-Habilitative Services
97-Rehabilitative Services
99- Multiple Modifiers

Review the proper use of each modifier.
Understand when each modifier should be applied.
  • The procedure has both a professional and technical component
  • Service is performed by more than 1 physician and/or in more than 1 location
  • Service has been increased or reduced
  • Only part of a service was performed
  • An adjunctive service was performed
  • Service or procedure was provided more than once
  • Unusual events occurred
  • Service was provided during a global period but is NOT included as part of the global reimbursement
 
goodmoring do you know if these test are current for this year
HIV screening is covered as a preventive service under the Affordable Care Act (ACA) if it is coded appropriately. The CPT codes used to report HIV screening for adolescents and adults are as follows:

  • 86689: HTLV or HIV antibody, confirmatory test
  • 86701: Antibody; HIV-1
  • 86702: Antibody; HIV-2
  • 86703: Antibody; HIV-1 and HIV-2, single assay
  • 87389: Infectious agent antigen detection by enzyme immunoassay technique, qualitative or semiquantitative, multiple-step method; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result
  • 87534: Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique
  • 87535: Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe technique
  • 87536: Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification
  • 87537: Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique
  • 87538: Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe technique
  • 87539: Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification
The Centers for Medicare & Medicaid Services (CMS) covers standard or rapid HIV screening tests reported using the following HCPCS G codes:

  • G0432: Infectious agent antibody detection by enzyme immunoassay (EIA) technique, HIV-1 and/or HIV-2, screening
  • G0433: Infectious agent antibody detection by enzyme-linked immunosorbent assay (ELISA) technique, HIV-1 and/or HIV-2, screening
  • G0435: Infectious agent antibody detection by rapid antibody test, HIV-1 and/or HIV-2, screening
 
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