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Ob-Gyn Coding Alert

Don't Forget Printed Additions of 90654, Mod 33

Published on Mon Nov 07, 2011

Remember how 90654 (Influenza virus vaccine, split virus, preservative-free, for intradermal use) went into effect Jan. 1, 2011? Now you can see it in your CPT manual. Also, you'll see modifier 33 (Preventive services) printed in your CPT manual. It, too, went into effect Jan. 1, 2011. This modifier 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. Part B pay: Unfortunately, you're not likely to get any love from your MACs with this new modifier. According to a Q&A on WPS Medicare's Web site, Medicare does not recognize modifier 33 (www.wpsmedicare.com/part_b/resources/provider_types/awv-faq.shtml). The reason? Medicare can only pay for preventive services that are specifically legislated and all of these services have their own "G" codes to describe them. You can only place modifier 33 on [...]
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