Cardiology Coding Alert

Question: Is modifier CT still effective in 2017?

Idaho Subscriber

Answer: Yes, modifier CT (Computed tomography services furnished using equipment that does not meet each of the attributes of the National Electrical Manufacturers Association [NEMA] XR-29-2013 standard) is still effective for 2017.

Use of the modifier indicates use of equipment that is not consistent with the CT equipment standard that Medicare Physician Fee Schedule (MPFS) payment is based on. In 2016, use of the modifier reduced reimbursement by 5 percent. In 2017, that reduction is 15 percent.

You can read more about the modifier in this MLN Matters article: www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9250.pdf.

The payment reduction is confirmed in the 2017 MPFS. There is an MLN Matters article with a summary here: www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9844.pdf.

Bonus tip: MLN Matters article MM9844, mentioned above, also describes new modifier FX (X-ray taken using film), which reduces technical component reimbursement by 20 percent. For a more in-depth MLN Matters article on modifier FX, see www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9727.pdf.