Wiki Modifier CS? When to use?

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kayleeevans907

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Hello, I am working at a physician's practice that is seeing people to be tested for covid-19. We do not bill labs, our sister hospital does, so this question is in relation to office visit charges:
When we see a patient and they are tested for covid-19 do we need to use a modifier CS to signify that this was done during the pandemic as a service in relation to testing for the virus? I had previously assumed that using Z20.828, Z03.818 & Z11.59 ICD-10 would be enough to signify to insurance to pay at the higher rates being advertised for covid/covid rule out services but after watching a webinar last week that addressed how CS has been repurposed to identify services related to covid-19 we're wondering if this is something we need to use/go back and put on all our other claims.
If you're using this in your practice any information/situations you've found it to be appropriate would be greatly appreciated.
Thank you
 
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You do not have to perform the lab, you just have to order the lab during the EM and then you can use the CS on the EM. So, the rule is the CS goes on and EM where a COVID-19 test is either performed or ordered.
 
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As time goes on I've been able to find a few more resources on this. The best resources I found was a webinar that was put out by CodingAid and another one by AAPC that my coworker attended (my apologies as I don't know the title). What we have found is essentially what b.cobuzzi has said above: if the service is related to testing use CS.
 
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CMS has put out a comprehensive FAQ document (128 pages) and you can find information about the CS modifier among other information in the FAQ, including great guidance on Telehealth and Hospital without walls, etc. This is where you can go to find it "in writing". The FAQ was just updated on June 19, 2020.

You can find the FAQs by Googling:
CMS COVID-19 FAQ Updated June 19
 
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b.cobuzzi said:
CMS has put out a comprehensive FAQ document (128 pages) and you can find information about the CS modifier among other information in the FAQ, including great guidance on Telehealth and Hospital without walls, etc. This is where you can go to find it "in writing". The FAQ was just updated on June 19, 2020.

You can find the FAQs by Googling:
CMS COVID-19 FAQ Updated June 19
Do you know if the CS modifier is appropriate for telephone E/M services? In the FAQs, I assumed that telephone E/M services would fall under "Office and other outpatient services". In addition, if one can append the CS modifier to "digital E/M services", why wouldn't the CS modifier apply to telephone E/Ms? We have Medicare patients that do not have access to video and COVID-19 lab tests are being ordered by physicians during a telephone E/M service. Any feedback would be greatly appreciated.
Click to expand...
 
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I found this, which says it's for both in-person visits and telehealth visits: https://codingintel.com/why-and-when-to-use-modifier-cs/
Question:

Why and when should we use modifier CS?

Answer:

Use modifier CS on visits related to testing for COVID-19.

Modifier CS: cost sharing waiver for COVID-19 testing

When you do, Medicare and private insurers will pay 100% of the claim, without any patient due cost sharing. The two laws that were passed require Medicare and commercial plans to cover these services without any cost sharing requirements or prior authorization or other medical management requirements.

Although the information about the modifier was released in April, it is retroactive to March 18, 2020.

You can use modifier CS on both in-person visits and visits via telehealth. If using modifier 95, for telehealth services, I suggest reporting it like this: 99214 -CS -95. Modifier CS affects payment, so use it first. Modifier 95 is informational.
 
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