JustCoding's Guide to Modifiers: Hospital Outpatient Edition

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JustCoding's Guide to Modifiers: Hospital Outpatient Edition

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JustCoding’s Guide to Modifiers: Hospital Outpatient Edition

Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H

Modifiers are a frequent audit target of CMS and the Office of Inspector General, with focused efforts against modifiers such as -25 and -59. JustCoding’s Guide to Modifiers: Hospital Outpatient Edition features a comprehensive explanation of when to report each CPT®/HCPCS modifier, including coding tips and the latest regulations and guidance. Each chapter contains exercises that let you use real-life documentation, including operative reports and case studies, to test your knowledge on how to apply each modifier.

This book will review the most recent guidance for each modifier, with citations from relevant regulatory documents.

Table of Contents

About the Author

1. Introduction
2. National Correct Coding Initiative Modifiers
   (Subsections: Modifiers -59, -XE, -XS, -XP, -XU, -58, -76 to -79, and -91)
3. Evaluation and Management Modifiers
   (Subsections: Modifiers -25 and -27)
4. Anatomical Modifiers
   (Subsections: Modifiers -50, -RT, -LT, -E1 to -E4, -F1 to -F9,
        -FA, -LC, -LD, -LM, -RC, -RI, -T1 to -T9, and -TA)
5. Reduced/Discontinued Services Modifiers
   (Subsections: Modifiers -52, -53, -73, and -74)
6. Medical Necessity Modifiers
   (Subsections: Modifiers -GA, -GX, -GY, and -GZ)
7. Screening Services Modifiers
   (Subsections: Modifiers -GG and -PT)
8. Outpatient Therapy Modifiers
   (Subsections: Modifiers -GN to -GP and -KX)
9. Miscellaneous Modifiers
   (Subsections: Modifiers -CA, -ET, -JW, and -PA to -PC)
10. Modifier Coding Compliance Quiz
11. Answer Key

Benefits:

  • Properly use modifiers to prevent audits
  • Reduce confusion about when to use modifiers
  • Get coding tips to clarify regulatory guidance and provide examples of which modifiers apply in different situations
  • Access case studies and operative reports to test your knowledge of modifiers

 

About the Author

Susan E. Garrison, CHCA, CHCAS, CCS-P, CHC, PCS, FCS, CPAR, CPC, CPC-H, is executive vice president of Healthcare Consulting Services at Magnus Confidential in Atlanta. Garrison has more than 25 years of experience in healthcare management, including the areas of documentation, coding, billing, and reimbursement for both outpatient hospital and physician services. She has conducted hundreds of engagements at hospitals across the country to improve hospital and physician compliance and reimbursement. She also worked for Medicare in Georgia for 12 years. Garrison is the executive director of compliance for the Association of Health Care Auditors and Educators, past president of the AAPC’s National Advisory Board, and past chair for the ACMCS.


Published: November 2015

Page count: 138
Dimensions: 8.5x11
ISBN: 978-1-55645-483-7