Coding and Reimbursement Basics for the Interventionalist-Using Modifiers for Reimbursement

Video Transcription

Video Summary

This video provides an overview of commonly used modifiers in medical coding. Modifiers are two-digit codes appended to CPT codes to provide additional information for payment or tracking purposes. Modifier 25 is used when an office visit or evaluation service is done on the same day as a test or minor procedure. Modifier 57 is used when the decision for a procedure with a 90-day global period is made on the same day as surgery. Modifier 59 is used to indicate that two codes that cannot be billed together due to an unbundling relationship should be paid separately. X modifiers also provide further clarity in certain situations. Modifier 22 is used when services go beyond the usual and must be reviewed for additional reimbursement. Modifiers 24, 78, and 79 are used for specific scenarios related to office visits, return to cath lab or operating room, and unrelated procedures performed within the global period. Modifiers 95 and GT are for synchronous telehealth services, while GQ is for asynchronous services. Payer-specific requirements and place of service codes are also important considerations for accurate reimbursement. It is crucial to review payer policies to ensure compliance. (No credits granted)

Keywords

modifiers

medical coding

CPT codes

payment

tracking purposes