General Surgery Coding Alert

Question:

Arkansas Subscriber

This year it is important to know about a few new modifiers, as well as some revisions to existing CPT modifiers.

For example, three existing CPT modifiers now include non-physician providers in the descriptors, as follows:

In previous years, some payers didn't allow non-physician providers to report their services with these modifiers since they specifically addressed "physician" care. Updating the descriptors should make it easier for you to report situations represented by modifiers 76, 77, or 78 to your payers.

In addition, CPT introduced modifier 33 (Preventive service), which allows you to tell your payer that you performed a preventive service and that the patient's deductible and coinsurance do not apply under the new Patient Protection and Affordable Care Act (PPACA) rules.

Surgical practices that perform colonoscopies should be aware of new modifier PT (Colorectal cancer screening test converted to diagnostic test or other procedure). Use this modifier when the surgeon converts a screening test to a diagnostic service.

New ABN modifier: You have a new modifier GU (Waiver of liability statement issued as required by payer policy, routine notice) to use in some cases when you should not use the revised modifier GA (Waiver of liability statement on file; individual) for advance beneficiary notifications (ABNs). Medicare hasn't yet provided instructions for correctly reporting modifier GU, but watch for updates in future issues of General Surgery Coding Alert.