tci ED Coding & Reimbursement Alert - 2020 Issue Q1

Reader Question: Avoid Modifiers on Unlisted Codes

Question: Our emergency department physician is performing multiple procedures during a trauma encounter. One of these procedures needs to be billed using an unlisted CPT® code. However, the existing CPT® code we are comparing it to would need a modifier 59 appended when billed along with the other procedures the physician performed. Should I append a modifier 59 to the unlisted procedure code? Texas Subscriber Answer: If a procedure you’re coding requires that it be submitted with an unlisted CPT® code, you should never append a modifier to the unlisted code. This rule exists across...

To read the full article, sign in and subscribe to tci ED Coding & Reimbursement Alert.

Thank you for choosing Find-A-Code, please Sign In to remove ads.