Wiki Modifier question for PT Billing

[jmuedes]

How do you know where to place a modifier if you are billing 97140 and 97530 do i place the 59 modifier on 97140???? I understand that modifier is needed but never sure which code should get the modifier any help???

 

[DrGreimel]

Answer to PT modifier question.

The answer is, the 97530 always gets the modifier 59 when billed with the 97140.

 

[roxannel]

According to CCI, the 97530 is a component of 97140 so, the modifier, if applicable, would be put on the 97530.

 

[jmuedes]

Thanks for your answer but how do you determine what code gets the modifier???

 

[mitchellde]

you need to look at the CCI edits, if it is a component of comprehensive edit then the component code gets the modifier, if you are look at a mutually exclusive paring then the column 2 code gets the modifier.
If you do not know what a CCI edit is, you need to go online and look this up. There are two different edits and you will need to examine both types, there is truely no way to know what type of edit you may have. Then you will get to the tables and there are several columns, read the instructions on how to interpret the information.