tci ED Coding & Reimbursement Alert - 2008 Issue 7

Reader Questions: Use Modifier on 'Involuntary' Services

Question: A patient presents to the ED with a police escort. An officer tells the front desk that the patient is there for a court-ordered drug test for cocaine. How should I code this encounter? Texas SubscriberAnswer: When the patient is ordered to submit to a procedure or service, attach modifier 32 (Mandated services) to the CPT code. This lets the payer know that the service is "related to mandated consultation and/or related services (e.g., third-party payer, governmental, legislative or regulatory requirement)," according to the CPT 2008 manual. On the claim, report the following: - 80100 (Drug...

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