Medicare Compliance & Reimbursement - 2015 Issue 29
Modifiers: These 3 Obscure Modifiers Could Clarify Your Services
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Article Overview
This article reviews a small set of less common billing modifiers and explains the general contexts in which they are discussed, including surgical team services, multiple outpatient hospital encounters, and claims with more than one modifier. It is aimed at coders and billing staff who need to understand when these modifiers come up, how they are presented in claims workflow, and why payer guidance matters.
Why This Topic Matters
Knowing these modifiers and the related reporting context can help coders recognize when a claim may need special attention for hospital E/M services, complex surgery reporting, or multiple-modifier placement. The article is useful for professionals who work with payer rules, documentation, and claim submission formatting.
Article Sections
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Modifier 66 Describes Team Surgeries
Introduces a surgical team modifier and discusses the general documentation and payer context associated with team-based procedures. The section also references Medicare fee schedule indicators and related reporting considerations.
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Modifier 27 Helps You Collect for Subsequent Hospital E/M Services
Covers the outpatient hospital encounter context in which a multiple-visit modifier is discussed. The section describes the general setting for same-day hospital E/M reporting and mentions the code groupings referenced in the article.
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Modifier 99 Denotes Additional Modifiers
Explains the use of a multiple-modifier indicator in claims situations where several modifiers are discussed together. The section also summarizes payer-communication considerations and the general claim-formatting context.
What You Will Learn
- The general purpose of several less common modifiers discussed in the article
- How team surgery, outpatient encounter, and multiple-modifier scenarios are presented at a high level
- Why documentation and payer guidance are emphasized in the article
- Which code families are referenced in connection with the modifiers
- How modifier use is discussed in relation to claim formatting and reporting placement
Who Should Read This
- Medical coders
- Billing staff
- Physician practice administrators
- Revenue cycle professionals
- Compliance staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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