AMA CPT® Assistant - 1997 Issue 6 (June)
Outpatient Hospital Use of Modifiers (June 1997)
June 1997 page 8 Coding Communication Outpatient Hospital Use of Modifiers With the implementation of section 9343 (a) of the Omnibus Budget Reconciliation Act of 1986 (OBRA), Medicare has required CPT coding for hospital outpatient claims since October 1, 1987. One of the differences in using CPT for outpatient hospital reporting for Medicare Part A relates to the use of modifiers. The Medicare Technical Advisory Group Outpatient Workgroup (M-TAG) recently reviewed all Level I (CPT) and Level II (HCPCS/National) modifiers to determine their applicability to hospital outpatient usage. The results of this review helped formulate recommendations for M-TAG presentation...
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Article Overview
This article explains a Medicare outpatient hospital coding update focused on modifier usage. It summarizes the approval process, the CPT and HCPCS modifier categories discussed, and the general hospital reporting context relevant to outpatient claims. The piece is useful for coders and hospital billing staff who need to understand what guidance was being introduced for outpatient reporting and which broad modifier groups were included.
Why This Topic Matters
It helps readers determine whether the article is relevant to hospital outpatient billing workflows tied to Medicare reporting and modifier adoption. The topic is especially important for professionals tracking historical coding guidance from HCFA, the National Uniform Billing Committee, and related outpatient reporting updates.
Article Sections
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June 1997 page 8
Introductory coding communication and the Medicare outpatient reporting context for the article topic.
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Approved Modifiers for Hospital Outpatient Use
Overview of the modifier approval process and implementation timing for outpatient hospital reporting.
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Level I (CPT) Modifiers
Summary of the CPT modifier group reviewed for hospital outpatient reporting and the associated administrative context.
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Level II (HCPCS/National) Modifiers
Summary of the HCPCS/National modifier group approved for outpatient hospital reporting.
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Hospital Use of CPT for Medicare
Background on the hospital-specific CPT edition and its role in Medicare outpatient reporting.
What You Will Learn
- How the article frames outpatient hospital reporting within Medicare guidance
- Which general modifier categories were reviewed and approved for hospital outpatient use
- How hospital-specific CPT materials are described in the article
- What organizations and policy processes are associated with the update
- What kinds of outpatient reporting topics the article covers at a high level
Who Should Read This
- Hospital outpatient coders
- Medical billing staff
- Compliance professionals
- Revenue cycle teams
- Coding educators
- Medicare reporting stakeholders
Codes Discussed
Modifiers Discussed
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