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Tuesday, February 14, 2017

Right CPT Modifier Will Bring in the Right Cash Flow and What is a CPT modifier?

Current Procedural Terminology (CPT) codes consist of five-digit numbers that represent individual services and procedures. The CPT is currently identified by the CMS as level I of Healthcare Common Procedure Coding System (HCPCS).

CPT codes may be further defined by starred designations for certain minor surgical procedures and by modifiers to explain an unusual circumstance associated with a service or procedure. 

What is a CPT modifier? 

CPT modifier is an added feature of the CPT to indicate that certain circumstances have changed the performance service. 

To cite an example - 51: When several surgeries are performed during the same operative session. Normally, most payers pay 100 percent for the first procedure, but decrease the reimbursement on the second, third, and fourth procedures. 

There are three ways to ensure that you are using modifiers correctly: 

Firstly, there are software technologies available that will prompt physicians to select the right modifiers at the time of service.

Secondly if the modifier is likely to reduce the amount of payment, leave the amount as it is and let the payer reduce it when he receives the claim. And if there’s likelihood of the modifier increasing the payment, increase the payment on the claim before you file it; don’t expect the payer to do it for you. 

Thirdly, you’ll do well to know the payers’ policies regarding the use of modifiers. Remember that rules may differ among the payers. 

Keeping pace with the CPT code list and modifiers can be a daunting challenge. This year saw around 700 CPT code changes and with just a few months to go before the year comes to an end, you’ll do well to gear yourself up for additional changes in the coming year.

2010 CPT Code Changes at one Place

January 2010 is just round the corner. As we step into the New Year, CPT will witness a plethora of changes, so much so that you’ll have a tough time keeping pace with what’s been added, what’s been revised, what’s been deleted. You’ll also need to know all the text and guideline changes if you are to make a mark in your coding career. 

As far as cardiology is concerned, the American Medical Association (AMA) has released four new Category I CPT codes to report cardiac CT (CCT) and Cardiac CT angiography (CCTA) exams. 

The new codes, to get going from January 1, 2010, are the result of several years of hard work put in by the American College of Cardiology (ACC), the Society of Cardiovascular CT (SCCT), the American Society of Nuclear Cardiology (ASNC) among others. 

For more of such cardiology and other CPT updates, you can get hold of the CPT book, which is a treasure trove of coding know how. But you’ll do well to remember that there are many a 2010 CPT code changes which will not make it to the printed form until the year 2011. 

But worry not! There are online sources of information which provides you with all the 2010 CPT code changes. If you want to know about all the 2010 CPT coding changes to cardiology, you can go for all-encompassing medical coding websites which will give you the key to your practice. 

Such websites also provide you with free trails which you can go for. Once you’re satisfied with the whole thing, you can register yourself for it. 

When you sign up for such a coding website, you’ll save yourself from having to flip through the big CPT book.

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