Medical Coding Fundamentals
Susan Goldsmith, CPC, CPC-H, CPC-P, CPC-I, CCP, CCS-P, CPEHR Marc Leib, MD, JD
McGraw-Hill
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| 2967638127 | 22 | INCREASED PROCEDURAL SERVICES Page 171 | 0 | |
| 2967638128 | 23 | UNUSUAL ANESTHESIA | 1 | |
| 2967638129 | 24 | UNRELATED EVALUATION AND MANAGEMENT SERVICE BY THE SAME PHYSICIAN DURING A POST OP PERIOD Page 155 | 2 | |
| 2967638130 | 25 | SIGNIFICANT SEPERATLY IDENTIFIABLE E/M SERVICE BY THE SAME PHYSICIAN ON THE SAME DAY OF THE PROCEDURE OR OTHER SERVICE Page 156 | 3 | |
| 2967638131 | 26 | PROFESSIONAL COMPONENT Page 162 | 4 | |
| 2967638132 | 32 | MANDATED SERVICES Page 174 | 5 | |
| 2967638133 | 47 | ANESTHESIA BY SURGEON Page 172 | 6 | |
| 2967638134 | 50 | BILATERAL PROCEDURES Page 164 | 7 | |
| 2967638135 | 51 | MULTIPLE PROCEDURES Page 165 | 8 | |
| 2967638136 | 52 | REDUCED SERVICES Page 173 | 9 | |
| 2967638137 | 53 | DISCONTINUED PROCEDURE Page 173 | 10 | |
| 2967638138 | 54 | SURGICAL CARE ONLY Page 163 | 11 | |
| 2967638139 | 55 | POSTOPERATIVE MANAGEMENT ONLY Page 163 | 12 | |
| 2967638140 | 56 | PREOPERATIVE MANAGEMENT ONLY Page 163 | 13 | |
| 2967638141 | 57 | DECISION FOR SURGERY Page 157 | 14 | |
| 2967638142 | 58 | STAGED OR RELATED PROCEDURE OR SERVICE BY THE SAME PHYSICIAN DURING THE POST OP PERIOD Page 158 | 15 | |
| 2967638143 | 59 | DISTINCT PROCEDURAL SERVICES - USED TO INDICATE THAT SERVICES THAT ARE USUALLY BUNDLED INTO ONE PAYMENT WERE PROVIDED AS SEPARATE SERVICES. Page 166 | 16 | |
| 2967638144 | 62 | TWO SURGEONS ACTED AS CO-SURGEONS Page 170 | 17 | |
| 2967638145 | 63 | PROCEDURE PERFORMED ON INFANTS LESS THEN 4 KG Page 172 | 18 | |
| 2967638146 | 66 | SURGICAL TEAM USED FOR COMPLEX SURGERIES Page 170 | 19 | |
| 2967638147 | 76 | REPEAT PROCEDURE OR SERVICE BY SAME PHYSICIAN Page 158 | 20 | |
| 2967638148 | 77 | REPEAT PROCEDURE BY ANOTHER PHYSICIAN Page 158 | 21 | |
| 2967638149 | 78 | UNPLANNED RETURN TO THE OPERATING PROCEDURE ROOM BY THE SAME PHYSICIAN FOLLOWING INITIAL PROCEDURE FOR A RELATED PROCEDURE DURING THE POST OPERATIVE PERIOD Page 159 | 22 | |
| 2967638150 | 79 | UNRELATED PROCEDURE OR SERVICE BY THE SAME PHYSICIAN DURING THE POST OP PERIOD Page 160 | 23 | |
| 2967638151 | 80 | ASSISTANT SURGEON Page 169 | 24 | |
| 2967638152 | 81 | MINIMUM ASSISTANT SURGEON Page 169 | 25 | |
| 2967638153 | 82 | ASSISTANT SURGEON ( WHEN QUALIFIED RESIDENT SURGEON NOT AVAILABLE) Page 169 | 26 | |
| 2967638154 | 90 | REFERENCE (OUTSIDE LABS) Not in textbook | 27 | |
| 2967638155 | 91 | REPEAT CLINICAL DIAGNOSTIC LAB TEST Page 168 | 28 | |
| 2967638156 | 92 | ALTERNATIVE LAB PLATFORM TESTING Not in textbook | 29 | |
| 2967638157 | 99 | THIS MODIFIER IS USED ONLY IF THE THIRD PARTY PAYER DOES NOT ACCEPT THE ADDITION OF MULTIPLE MODIFIERS TO A CODE. Not in textbook | 30 | |
| 2972155371 | TC | Identifies the technical component of a procedure that has both a professional and technical component. Most often used by hospitals, imaging centers, etc that have the equipment to perform the imaging procedure when that entity is NOT also performing the associated professional services. Page 162 | 31 | |
| 2972171746 | 33 | Primary purpose of the service is the delivery of a recommended preventive service. Page 175 | 32 | |
| 2972176959 | P1 | Physical status modifiers to identify how healthy or sick a particular patient is before undergoing anesthesia, only added to the anesthesia CPT codes (00100-01999). A normal healthy patient. Page 175 | 33 | |
| 2972188908 | P2 | Physical status modifiers to identify how healthy or sick a particular patient is before undergoing anesthesia, only added to the anesthesia CPT codes (00100-01999). A patient with mild systemic disease. Page 175 | 34 | |
| 2972192649 | P3 | Physical status modifiers to identify how healthy or sick a particular patient is before undergoing anesthesia, only added to the anesthesia CPT codes (00100-01999). A patient with severe systemic disease. Page 175 | 35 | |
| 2972194592 | P4 | Physical status modifiers to identify how healthy or sick a particular patient is before undergoing anesthesia, only added to the anesthesia CPT codes (00100-01999). A patient with severe systemic disease that is a constant threat to life.. Page 175 | 36 | |
| 2972197653 | P5 | Physical status modifiers to identify how healthy or sick a particular patient is before undergoing anesthesia, only added to the anesthesia CPT codes (00100-01999). A moribund patient who is not expected to survive without the operation. Page 175 | 37 | |
| 2972203416 | P6 | Physical status modifiers to identify how healthy or sick a particular patient is before undergoing anesthesia, only added to the anesthesia CPT codes (00100-01999). A brain-dead patient whose organs are being removed for donor purposes. Page 175 | 38 | |
| 2972211989 | Genetic Modifiers | CPT codes identify general molecular diagnostic procedures and cytogenetic studies. These modifiers are added to the general codes to identify the specific disease for which the tests were performed. Located in Appendix I of the CPT manual. | 39 | |
| 2972238997 | Anatomical Modifiers | HCPCS modifiers are used to provide additional information related to the specific anatomical site of the procedure. They may be used with a single code to indicate the specific anatomical structure. They also may be used in combination with modifier 59 to identify that the second procedure was performed on a separate anatomical site. | 40 | |
| 2972249967 | E1-E4 | Used to identify specific eyelids (see page 177 and Anatomical Modifiers flash card) | 41 | |
| 2972257618 | FA, F1-F9 | Used to identify specific fingers. (see page 177 and Anatomical Modifiers flash card) | 42 | |
| 2972261540 | TA, T1-T9 | Used to identify specific toes. (see page 177 and Anatomical Modifiers flash card) | 43 | |
| 2972263581 | RC, LC, and LD | Used to identify specific coronary arteries. (see page 177 and Anatomical Modifiers flash card) | 44 | |
| 2972267406 | LT and RT | Used to identify left and right. (see page 177 and Anatomical Modifiers flash card) | 45 | |
| 2972270303 | Ambulance Modifiers | Specific modifiers must be used to identify the pickup point and destination of the ambulance trip. Use single-digit characters to identify each of these locations and combine into a two-digit code. | 46 | |
| 2972282878 | D | Diagnostic or therapeutic site other than a hospital or physician's office. (see page 177 and Ambulance Modifiers flash card) | 47 | |
| 2972288892 | H | Hospital (see page 177 and Ambulance Modifiers flash card) | 48 | |
| 2972290061 | J | Freestanding end-stage renal disease (ESRD) facility (see page 177 and Ambulance Modifiers flash card) | 49 | |
| 2972292853 | N | Skilled nursing facility (SNF) (see page 177 and Ambulance Modifiers flash card) | 50 | |
| 2972295152 | P | Physician's office (see page 177 and Ambulance Modifiers flash card) | 51 | |
| 2972297271 | R | Residence (see page 177 and Ambulance Modifiers flash card) | 52 | |
| 2972297272 | S | Scene of an accident (see page 177 and Ambulance Modifiers flash card) | 53 | |
| 2972299257 | Equipment Modifiers | Durable medical equipment (DME) and other medical equipment modifiers are used to identify these equipment-related options. (see page 178 and Equipment Modifiers flash card) | 54 | |
| 2972314614 | NU | Equipment is new. (see page 178 and Equipment Modifiers flash card) | 55 | |
| 2972316452 | UE | Equipment is used. (see page 178 and Equipment Modifiers flash card) | 56 | |
| 2972317678 | RR | Equipment is rented. (see page 178 and Equipment Modifiers flash card) | 57 | |
| 2972317679 | LL | Equipment is leased; lease payments are applied to purchase price. (see page 178 and Equipment Modifiers flash card) | 58 |
