CPC Certification Training In hasmathpet

Best CPC Certification Training Institute in hasmathpet

CPC Certification Training in Hyderabad

Modifiers in Medical Billing

Modifiers are two-character codes added to CPT (Current Procedural Terminology) or HCPCS (Healthcare Common Procedure Coding System) codes to provide additional information about a procedure or service. They are used to indicate that a service was altered in some way but did not change the overall definition of the code. Modifiers help clarify the services rendered and ensure accurate reimbursement from insurance companies.

Common uses of modifiers include:

  • Modifier 25: Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure.
  • Modifier 59: Distinct procedural service, indicating that procedures performed during the same session were independent of each other.
  • Modifier 26: Professional component, indicating that a physician provided only the professional component of a service, such as interpreting a radiological exam, while another party provided the technical component.

Medical billers must understand the proper use of modifiers to prevent claim denials and ensure the correct reimbursement amount for services rendered.

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