Modifier 59 is an important NCCI PTP-associated modifier that physicians and providers often use incorrectly. This booklet will help you use this modifier correctly.

A GA modifier is attached to the colonoscopy code, which alerts Medicare that it is expected to be denied as not reasonable and necessary and that the patient was informed.

Reduce denials, improve claim accuracy, and stay compliant with this easy guide. Use only when necessary—otherwise, use X modifiers (XE, XP, XS, XU). Ensure documentation supports a …

PD Right foot, third digit Right foot, fourth digit Right foot, fifth digit Principal physician of record Service provided as part of Medicaid early periodic screening diagnosis and treatment …

For a list of approved modifiers, refer to the Modifiers: Approved List section in this manual. Some procedures do not need further clarification with a modifier. Use of modifiers other than those …

While CPT does not outline required documentation for modifier 25, its use indicates that documentation is available in the patient’s record to support the reported E/M service as …

Reimbursement Policy Modifier Reference Guide This document is a reference guide to provide information regarding modifiers related to Medica reimbursement policies. The use of …