The Complete Procedure Coding Book By Shelley C. Safian, MAOM/HSM, CCS-P, CPC-H, CHA Chapter 15 HCPCS Level II Modifiers Copyright © 2009 by The McGraw-Hill Companies, Inc. All rights reserved McGraw Hill/Irwin

Learning Outcomes Apply the guidelines to correctly use HCPCS Level II modifiers. Determine when to appropriately use HCPCS Level II modifiers. Distinguish between the various functions of HCPCS Level II modifiers. 15-2

Learning Outcomes Append multiple modifiers in the proper sequence. Utilize HCPCS Level II modifiers for statistical analysis of services. Differentiate between CPT modifiers and HCPCS modifiers. 15-3

Introduction HCPCS Level II modifiers provide additional information about a particular health care encounter. 15-4

HCPCS Level II All HCPCS Level II modifiers are listed in Appendix 2 in alphabetical order. 15-5

Guidelines HCPCS Level II modifiers can be appended to both CPT codes or HCPCS Level II codes. Before using, assure the third-party payer accepts these modifiers. 15-6

Modifiers Explain details about: Providers Wound care Anesthesia Services Ophthalmology/Optometry ESRD/Dialysis Pharmaceuticals 15-7

Modifiers Explain details about: Items/services Purchase/rental items Deceased patients Claims and documentation Anatomical sites 15-8

Modifiers Explain details about: Family services Treatments/screenings Transportation Funded programs Individual/group services Prosthetics 15-9

Modifiers Explain details about: Durable medical equipment Location Podiatric care Recording Other services Medicaid services Special rates 15-10

Chapter Summary These modifiers, as with those you learned about in Chapter 3, help identify specific situations or conditions that may be out of the ordinary and get claims paid more accurately and quickly