Updated Your 2011 Cpt Modifier Options? If Not, Do It Now!

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A general surgery coder asked, "We read lots of information about CPT 2011 code changes, however are there any modifier changes we should be aware of?


In 2011, it is important to know about a few new modifiers, as well as some revisions to existing CPT modifiers. For instance, three existing CPT modifiers now include non-physician providers in the descriptors as here:


76 -- Repeat procedure or service by same physician or non-physician provider


77 -- Repeat procedure or service by another physician or non-physician provider


78 -- Unplanned return to the operating/procedure room by the same physician or non-physician provider following initial procedure for a related procedure during the postoperative period).


Earlier, some payers did not allow non-physician providers to report their services with these modifiers because they specifically addressed "physician" care. Updating the descriptors should make it easier for you to code situations represented by modifiers 76, 77, or 78 to your payers.


Apart ...
... from this, CPT introduced modifier 33 (Preventive service), which allows you to tell your payer that you performed a preventive service and that the patient's deductible and coinsurance do not apply under the new PPACA (Patient Protection and Affordable Care Act) rules.


Surgical practices that carry out colonoscopies should know about new modifier PT (Colorectal cancer screening test converted to diagnostic test or other procedure). Make use of this modifier when the surgeon converts a screening test to a diagnostic service.


Just-in ABN modifier: You have a just-in modifier GU (Waiver of liability statement issued as required by payer policy, routine notice) to use in some instances when you shouldn't use the revised modifier GA (Waiver of liability statement on file; individual) for ABNs. Medicare has not yet provided instructions for correctly reporting modifier GU; however look out for updates and other specialty-specific articles to assist your general surgery coding. , sign up for a good medical coding resource like Coding Institute.