JustCoding's Guide to Modifiers: Hospital Outpatient Edition

  • Publish Date: 2015-10-01
  • Binding: Paperback
  • Author: HCPro a division of BLR;Susan E. Garrison CHCA CHCAS CCS-P CHC PCS FCS CPAR CPC CPC-H

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Modifiers are a frequent audit target of CMS and the Office of Inspector General, with focused efforts against modifiers such as -25 and -59. JustCoding's Guide to Modifiers: Hospital Outpatient Edition features a comprehensive explanation of when to report each CPT/HCPCS modifier, including coding tips and the latest regulations and guidance. Each chapter contains exercises that let you use real-life documentation, including operative reports and case studies, to test your knowledge on how to apply each modifier.

This book will review the most recent guidance for each modifier, with citations from relevant regulatory documents.

Table of Contents

About the Author

1. Introduction

2. National Correct Coding Initiative Modifiers

(Subsections: Modifiers -59, -XE, -XS, -XP, -XU, -58, -76 to -79, and -91)

3. Evaluation and Management Modifiers (Subsections: Modifiers -25 and -27)

4. Anatomical Modifiers

(Subsections: Modifiers -50, -RT, -LT, -E1 to -E4, -F1 to -F9, -FA, -LC, -LD, -LM, -RC, -RI, -T1 to -T9, and -TA)

5. Reduced/Discontinued Services Modifiers (Subsections: Modifiers -52, -53, -73, and -74)

6. Medical Necessity Modifiers

(Subsections: Modifiers -GA, -GX, -GY, and -GZ)

7. Screening Services Modifiers

(Subsections: Modifiers -GG and -PT)

8. Outpatient Therapy Modifiers

(Subsections: Modifiers -GN to -GP and -KX)

9. Miscellaneous Modifiers

(Subsections: Modifiers -CA, -ET, -JW, and -PA to -PC)

10. Modifier Coding Compliance Quiz

11. Answer Key


- Properly use modifiers to prevent audits
- Reduce confusion about when to use modifiers
- Get coding tips to clarify regulatory guidance and provide examples of which modifiers apply in different situations
- Access case studies and operative reports to test your knowledge of modifiers

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