tci General Surgery Coding Alert - 2003 Issue 6

READER QUESTION: No Fixed Guidelines for -63

Question: What can you tell me about the new-for-2003 modifier -63? Georgia SubscriberAnswer: Insurers have yet to implement guidelines for modifier -63 (Procedure performed on infants less than 4 kg), but CPT explains the rationale for the modifier by noting, "Procedures performed on neonates and infants up to a present body weight of 4 kg may involve significantly increased complexity and physician work commonly associated with these patients." The AMAs CPT Changes 2003: An Insiders Guide further notes, "In this population of patients there is a significant increase in work intensity, specifically related to temperature control, obtaining IV...

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