Question:
We read lots of information about CPT 2011 code changes, but are there any modifier changes we should be aware of?Kentucky Subscriber
Answer:
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 nonphysician providers in the descriptors, as follows:
- 76 -- Repeat procedure or service by same physician or non-physician provider
- 77 -- Repeat procedure or service by another physician or non-physician provider
- 78 -- Unplanned return to the operating/procedure room by the same physician or non-physician provider following initial procedure for a related procedure during the postoperative period).
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.
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 notice of non-payment (ABNs). Medicare has not yet provided instructions for correctly reporting modifier GU.