Difference between modifiers and level II national usage

[Linda]

Hello can you please cover the determining fact between using Modifers 22,23,24,25 etc and the level II (HCPCS national) is it one goes on e/ m level and the other on the procedure code ? Thanks Linda Stricklin

 

[Luna]

Hi Linda,
I'm pretty sure some one very qualified will be here shortly to answer your questions. I'm getting ready to enroll in some training though and looking forward to it. I was curious though if you downloaded the "Free Modifier Job Aid". If you go to the Home page. The link is one of the bottom boxes that says "Free Coding Tools & Downloads". I've got it and can tell it is going to be an invaluable aid.
Anyway, I am sure Alicia or Laureen or Ruth or someone will come by and help you out and I'll be anxious to learn more myself.

 

[Linda]

Hi Luna
It was a test question that I got wrong. Both sets of Modifers were an option to use. Was just wondering, on the fly how a person would know which to use.
A modifer 59 question too. When a PT is seen in ER was assigned an E/M level and an IM was given, is it appropriate to add modifer -59 to the injection code. Full of questions tonight ))))) thanks Linda

 

[Linda]

Got the download, now just need to print it. My son ordered one online. It didn't come with ink or a cable. lOL and he calls me the slow one. I at least would have looked to see if the ink came with it. No wonder it was a good price ))) Linda sorry think I am chatting in wrong area.

 

[Luna]

Nope, this is a good place to chat. I hope that aid is a help to you. It's greek to me at this point, but I can tell its a great aid and I can't wait to know more about it. Are you a student, or coder or other? I'm saving up to enroll late this month. I come here to keep myself fired up about it. Pretty soon I'll be posting legitimate questions and maybe even getting educated enough to give legit answers. Hope your ink comes soon.

 

[Linda]

Student right now. Did the coding and auditing for ED for 10 years never got certified so the computer charting got my job. But it gives me time to get through school I don't know how people work full time and do all the reading and testing that is required. I don't recall nursing school being as time consuming but I'm sure it was. Has been long enough ago to have forgotten most of the hard times. I do enjoy learning new things. All the years I did that job have leanered from this class we were not always doing it right. So I guess always new things to learn. Check out utube has some good sites and info there too. Helped me with my ICD class. Kay gooding did the classes for the HIT program.

 

[Ruth Sheets]

Linda, Luna's suggestion to use the Free Modifier Job Aid is a good one. Also, you probably should take the time to read through CPT Appendix A where the modifiers are described, then use the Modifier Grid to remind you of where the modifier fits in. You are correct that most modifiers are either intended for E/M OR for non-E/M procedures. Only modifiers -32 (mandated services) and -52 (reduced services) may be used with both E/M and non E/M procedures.

Regarding your other question: When a PT is seen in ER was assigned an E/M level and an IM was given, is it appropriate to add modifer -59 to the injection code? The answer is no, it is not appropriate. To use -59 you would need 2 non E/M procedures that are not normally reported together, and you only have one non E/M procedure (the injection).

It takes a while to learn how to use modifiers. A good medical coding course will provide you with lots of examples so you can understand when to use which modifier. CodingCertification.Org's Physician Based Medical Coding will provide a lot of examples and information regarding modifiers and other topics you will need to know to become certified.

 

[Linda]

Hello
Is there any time modifer -59 would be used after the second IM. I believe the coders used this code for maybe the second IM given at same encounter. With -25 appended to the E/M level. I could be wrong. Linda Stricklin.

Linda, Luna's suggestion to use the Free Modifier Job Aid is a good one. Also, you probably should take the time to read through CPT Appendix A where the modifiers are described, then use the Modifier Grid to remind you of where the modifier fits in. You are correct that most modifiers are either intended for E/M OR for non-E/M procedures. Only modifiers -32 (mandated services) and -52 (reduced services) may be used with both E/M and non E/M procedures.

Regarding your other question: When a PT is seen in ER was assigned an E/M level and an IM was given, is it appropriate to add modifer -59 to the injection code? The answer is no, it is not appropriate. To use -59 you would need 2 non E/M procedures that are not normally reported together, and you only have one non E/M procedure (the injection).

It takes a while to learn how to use modifiers. A good medical coding course will provide you with lots of examples so you can understand when to use which modifier. CodingCertification.Org's Physician Based Medical Coding will provide a lot of examples and information regarding modifiers and other topics you will need to know to become certified.

 

[Ruth Sheets]

Linda, See answer in thread here:
https://www.cco.us/forum/threads/modifer-59.267/