# Modifier TD



## arrana (Jan 15, 2016)

Does anyone use modifier TD for services performed during an RN only visit? For example, patient comes in for a B12 shot which was ordered by the provider. Patient brings in product, the only service to bill is the 96372. Do you add the TD modifier to indicate this was a nursing visit billed under the provider name/number? If you do, what are your results?


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## treyzer96 (Jul 1, 2020)

I realize this post is late but I wanted to share some links about the TD modifier. I was researching today about Depo Provera Injections and the need for TD modifier. The TD modifier ONLY should be appended to the E&M visit according to Medi-CAL (unsure of your location-this is California Medicaid guidance). It states when medroxyprogesterone acetate 150mg is administered for contraceptive purposes it should be billed with J3480-U8 and if administered by a nurse with an E&M visit the TD modifier belongs on the E&M visit. I struggled to understand why we would bill an E&M with a nurse only visit with a contraceptive management dx if only an injection was given (wouldn't we just bill 96372 for administration)? Then I found rationale from AAFP that the nurse should be using their expertise on whether it is appropriate to administer the injection and must evaluate for possible pregnancy. The documentation must be there to support the E&M charge though. 
* Medi-CAL Link explaining family planning and TD modifier
http://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/part2/famplanning_m00o03.doc 
*AAPC link explaining proper billing for 96372
https://www.aapc.com/blog/27677-96372-done-right/
*AAFP link stating their rationale for billing E&M for nurse visits
https://www.aafp.org/fpm/2000/0700/p39.html


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