| Current Procedural Terminology (CPT) codes consist | | | | modifiers correctly: |
| of five-digit numbers that represent individual services | | | | Firstly, there are software technologies available that |
| and procedures. The CPT is currently identified by the | | | | will prompt physicians to select the right modifiers at |
| CMS as level I of Healthcare Common Procedure | | | | the time of service. |
| Coding System (HCPCS). | | | | Secondly if the modifier is likely to reduce the amount |
| CPT codes may be further defined by starred | | | | of payment, leave the amount as it is and let the payer |
| designations for certain minor surgical procedures and | | | | reduce it when he receives the claim. And if there's |
| by modifiers to explain an unusual circumstance | | | | likelihood of the modifier increasing the payment, |
| associated with a service or procedure. | | | | increase the payment on the claim before you file it; |
| What is a CPT modifier? | | | | don't expect the payer to do it for you. |
| CPT modifier is an added feature of the CPT to | | | | Thirdly, you'll do well to know the payers' policies |
| indicate that certain circumstances have changed the | | | | regarding the use of modifiers. Remember that rules |
| performance service. | | | | may differ among the payers. |
| To cite an example - 51: When several surgeries are | | | | Keeping pace with the CPT code list and modifiers |
| performed during the same operative session. | | | | can be a daunting challenge. This year saw around |
| Normally, most payers pay 100 percent for the first | | | | 700 CPT code changes and with just a few months |
| procedure, but decrease the reimbursement on the | | | | to go before the year comes to an end, you'll do well |
| second, third, and fourth procedures. | | | | to gear yourself up for additional changes in the |
| There are three ways to ensure that you are using | | | | coming year. |