AMA CPT® Assistant - 2013 Issue 8 (August)

Coding Brief: Modifier 32, Mandated Services (August 2013)

August 2013 page 12 Coding Brief: Modifier 32, Mandated Services Mandated services are defined as required services, such as those required by a third-party payer, governmental, legislative, or regulatory requirement, and may be identified by adding modifier 32 to the basic procedure. Under certain circumstances, some third-party payers may require a patient to undergo certain mandated services, such as obtaining second or third opinions, before undergoing a procedure and/or therapeutic service. When a patient is scheduled for this type of mandated service, the procedure code for the service provided is reported with modifier 32 appended to the code. Modifier...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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