Chapter 3 Modifier Part 2 Flashcards
Minimum Assistant Surgeon:Minimum surgical assistant services are identified by adding modifier ___ to the usual procedure number.
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Assistant Surgeon (when qualified resident surgeon not available):The unavailability of a qualified resident surgeon is a prerequisite for use of modifier ___ appended to the usual procedure code number(s).
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Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System:Synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional.
The totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
Modifier ___ may only be appended to the services listed in Appendix P. Appendix P is the list of CPT codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
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Habilitative Services: Services which help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. These services also help an individual keep, learn or improve skills and functioning for daily living.
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Rehabilitative Services: Services which help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled.
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Multiple Modifiers:Under certain circumstances two or more modifiers may be necessary to completely delineate a service. In such situations modifier ___ should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service.
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Multiple Procedures:When multiple procedures, other than E/M services, physical medicine and rehabilitation services, or provision of supplies (eg, vaccines), are performed at the same session by the same provider, the primary procedure or service may be reported as listed. The additional procedure(s) or service(s) may be identified by appending modifier ___ to the additional procedure or service code(s).Note:This modifier should not be appended to designated add-on codes (see Appendix D).
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Unusual anesthesia: reported in circumstances when local or no anesthesia is normally needed. In cases where an unusual situation exists concerning a patient, modifier ____ describes that general anesthesia is required in this case. Examples of these situations may include extreme age, mental retardation, or psychiatric conditions.
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Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Healthcare Professional During a Postoperative Period: can be reported with an E/M service provided during the postoperative period by the same physician who performed the original procedure. However the E/M service must be unrelated to the condition for which the original procedure was performed.
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Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Healthcare Professional on the Same Day of the Procedure or Other Service: tells the insurer that the patient’s condition required a significant, separately identifiable E/M service on the same day as a procedure. CMS guidelines state that modifier ___ should be appended to the E/M code when reported with a minor procedure when a significant, separately identifiable service is also performed. always appended to the E/M code, never to the surgical code. Different diagnoses are not required for reporting of the E/M services on the same date.
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