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how to use modifier 55

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Global Surgery Fact Sheet – CMS

www.cms.gov

The physician must use the same CPT code for global surgery services billed
with modifiers “-54” or “-55.” The same date of service and surgical procedure
code.

Medicare Claims Processing Manual – CMS

www.cms.gov

20.4.6 – Payment Due to Unusual Circumstances (Modifiers “-22” and. “-52”) …..
of the INR monitor, instructions regarding the use of a blood sample for reporting
home ….. Residential Substance Abuse Treatment Facility (POS code 55);.

MLN Matters® Article MM6740 – CMS

www.cms.gov

Nov 8, 2011 … regarding the use of consultation codes and the addition of new …. The principal
physician of record will append modifier “-AI” Principal Physician …. 55. 100.
99215. 40. 70. 115. 99324. 20. 50. 95. 99325. 30. 60. 105. 99326.

Surgical Modifiers – Medi-Cal

files.medi-cal.ca.gov

Jan 5, 2016 … Additional Surgical Modifiers: Anesthesia Drugs & Supplies: UA, UB. Evaluation
and Management: 24, 25. General Use: 22, 26, 52, 54, 55, 62, …

Transmittal R2997CP – CMS

www.cms.gov

Jul 25, 2014 … Examples of vital organ system failure include, but are not limited to: ….. CPT
modifiers -54 and -55 are used indicating the transfer of care from …

OWCP Surgical Services – Global Surgery

www.dol.gov

MMM Maternity codes; usual global period does not apply. XXX … postoperative
care of the patient; identified by modifiers –54, –55, and –56). •. Assistant …

Appendix E: Modifiers that affect payment

www.lni.wa.gov

Note: Only modifiers that affect payment are listed in this Appendix. Refer to
current CPT® and … should use modifiers –54, –55, and –56. These modifiers
are …

Coding for Quality-A Handbook for PQRI Participation – Find-A-Code

www.cms.hhs.gov

Jun 18, 2007 … 2) Reporting modifier 8P is available for use only with CPT II codes to ….. 155.
Syncope. 55. Electrocardiogram Performed for Syncope. 157.

Professional Services Fee Schedule HCPCS Level II Fees

www.lni.wa.gov

Jul 1, 2016 … Procedure code for facility outpatient use only. … value that is allowed when
modifier -55 is billed. … rules for multiple surgeries do not apply.

Physician, M.D. and Osteopath, D.O., Advanced … – Nevada Medicaid

www.medicaid.nv.gov

Providers may also use the Authorization Criteria search function in the … must
continue to use a zero rate for reimbursement for VFC vaccines, or the SL
modifier. …. Covered diagnosis codes for acute conditions are: T53.91XA, T55.
0X1A, …

Update 2015-62 – ForwardHealth Portal – State of Wisconsin

www.forwardhealth.wi.gov

Dec 28, 2015 … October 2015 Update (2015-55), titled “Provider Enrollment for the New ….. Use
of CPT procedure codes and applicable modifiers is required …

table of contents – SCDHHS.gov

www.scdhhs.gov

Dec 1, 2016 … Claims Filed via the Web Tool: Use of Emergency Indicator . ….. with the
procedure code, or invalid use of modifiers, will … 55. Residential Substance
Abuse Treatment Facility. 56. Psychiatric Residential Treatment Center. 57.

Instructions and Guidelines090111–022113 – Illinois Workers …

www.iwcc.il.gov

Feb 21, 2013 … modifiers in Section 8(F) of the Instructions and Guidelines shall be used.7 … The
use of other optional modifiers may be appropriate. ….. medicine include, but are
not limited to: 22, 32, 51, 52, 53, 55, 56, 57, 58, 59, 76, 77, 78, …

billing resource manual – Georgia Department of Community Health

dch.georgia.gov

New providers are now able to use the GHP's Web Portal as a single source …..
and the admin code for patients 19-20 years (The EP Modifier must be used). ….
7-55yrs. Varicella. 90716. V05.4. $96.57. 2.23. Td, Tetanus, diphtheria toxoid, …

481-000-65 final – Nebraska Department of Health and Human …

dhhs.ne.gov

Aug 6, 2014 … The billing instructions in this appendix apply when billing Nebraska Medicaid,
also known as the ….. procedure code with modifier "55." 24E.

TABLE OF CONTENTS – Utah Medicaid – Utah.gov

medicaid.utah.gov

Jul 1, 2016 … 16-55 2016 MEDICAID STATEWIDE PROVIDER TRAINING . …. providers do not
use this cover sheet, their documents will not be processed …. Append a "UC"
modifier to labor and delivery claims, when the delivery is 39 …

10-144 CH. 101 MAINECARE BENEFITS MANUAL … – Maine.gov

www.maine.gov

Jun 3, 2015 … guidelines allow for the use of numeric modifiers up to five characters long (in
addition to the … As with the procedure codes, there are two types of modifiers:
CPT modifiers, which are …. 85:ng 6 £02 mmmv GEE inflofla 55».

Best Practices in Developing Proprietary Names for Drugs – FDA

www.fda.gov

What should sponsors consider in the selection and evaluation of a modifier? ….
medication use or patient harm while the medication is in the control of the
healthcare … 55. 4 See the FDA draft guidance for industry Safety Considerations
for …

MO HealthNet Professional Billing Book – Missouri Department of …

dss.mo.gov

Jun 21, 2013 … not use either of these numbers for requests for pre-certifications of MRI, MRA,
CT,. CTA, PET … number and date of birth, or if a newborn, using the mother's MO
….. and applicable modifier(s), if any, ….. 55 – Mass Adjustment.

Transcript – HRSA

www.hrsa.gov

Mar 29, 2016 … Slide 55 – this pertains to MSP Claims. All claims to …. well as from an under-
coding perspective but use of Modifier 59 is going to become a …



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