Cardiology Coding Alert

Question: Some of our payers deny claims with modifier 33 because they state the modifier is invalid. Can you explain this modifier to me and how we should be using it? Mississippi Subscriber Answer: The full definition of modifier 33 (Preventive services) reads as follows: "When the primary purpose of the service is the delivery of an evidence based service in accordance with a US Preventive Services Task Force A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by adding 33 to the procedure. For separately reported services specifically identified as preventive, the modifier should not be used."Modifier 33 isn't appropriate for every preventive service. Only report it for services that (1) are not inherently preventive and (2) were provided as preventive in the particular situation. Example: You practice performs a lipid panel on a 40-year-old [...]