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Primary Care Coding Alert

Reader Question:

Scrutinize the Preventive Care to Determine if Modifier 33 Applies

Published on Mon Jul 02, 2012

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 SubscriberAnswer: Modifier 33 (Preventive services) was a late addition to CPT® 2012; you'll find it in the Appendix A but not inside the front cover with other common modifiers. The full descriptor 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 prevent 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 [...]
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