Pediatric Coding Alert

Question: I noticed that the September Pediatric Coding Alert didn't include a hyphen before a modifier. What is the reason behind this change?


Kentucky Subscriber

Answer: You're an astute reader. The AMA has dropped the hyphen from its modifier publications including CPT's coding manuals and CPT Assistant.

The AMA used the hyphen as a formatting convention to ensure that people realized an upcoming number was a modifier.

The symbol also avoided numerical confusion. The dash alerted you that the final two digits--such as "-25"--weren't part of the CPT code.

Good news: You're probably used to looking at modifiers without a hyphen preface on your claim forms. The hyphen never mattered for charge entry.

On a CMS-1500 written or electronic claim, you enter the five-digit CPT code and then enter the modifier in a separate place. The written world will now mirror that method.

The change's effect: Modifier -25 becomes modifier 25. Coding Institute publications will, however, maintain the hyphen when designating a modifier-appended CPT code, such as 99202-25 (Office or other outpatient visit for the evaluation and management of a new patient; significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).

You may think written correspondence should reflect the new streamlined modifier look, but experts don't advocate changing your modifier style. Eliminating the hyphen in your appeal letters is unnecessary. The hyphen lets the reader know you didn't omit any digits from a code.

The hyphen also emphasizes the modifier. Because insurers tend to ignore modifiers, maintaining the hyphen in your written correspondence is a good idea.