CPT codes break down a doctor's practice into specific acts and their standard billing rates.
Current Procedural Terminology, or CPT, is a system of numeric codes created by the American Medical Association. CPT coding identifies types of medical services, when and where they are performed, and by whom. CPT codes are used for assigning costs to medical procedures, insurance reimbursement and billing of insurers and the government.
Procedure
The initial CPT code for the medical procedure is entered. Healthcare Common Procedure Coding System -- HCPSCS -- level two modifiers indicate if a procedure or service has been modified. CPT/HCPSCS level two modifiers are added to CPT codes if appropriate. The code may be appended by the medical coder or someone performing quality control reviews of the coding work. If the appended code is input by someone other than the coder, a triangle will be added next to the code.
Modifiers
Modifier codes are two digits. They are added after the initial CPT code. CPT add-on codes are identified by a plus sign. Modifier -50 identifies when a procedure was performed on two matching body parts such as both eyes and legs. The modifier --LT indicates it was done on the left side only. The modifier --RT indicates the procedure was only done on the right side. Modifier -25 represents a medical evaluation in addition to other services. Modifier -91 indicates repeated lab work on the same day.
No Modifiers Required
Modifiers are not required to indicate a procedure is bilateral if the CPT code is considered inherently bilateral. Modifier -76 identifies procedures performed several times in one day. The first procedure does not have a modifier. Subsequent procedures have the -76 modifier added.
Tags: have modifier, HCPSCS level, HCPSCS level modifiers, indicate procedure, initial code, level modifiers, Modifier identifies