Coding with Modifiers, 6th Edition provides guidance on how and when to use modifiers to avoid costly payment delay and denials. Modifiers create clear, concise communications between the provider and payer, and are essential to the coding process.
NEW features added to the revised sixth edition:
- Documentation and Other Considerations- section at the end of every chapter to highlight important clinical documentation improvements for each modifier as well as how to apply each modifier in auditing, and analytics, etc.
- Revised, updated, and/or deleted codes- CPT and HCPCS codes, HCPCS modifiers, guidelines, advice/alert notes, clinical examples, modifier usage logic, etc, for all affected content, as appropriate.
- Multiple New Features- including Alert/Advice Notes, Coding Tips, Definitions, various types of end-of-chapter exercises, such as multiple choice, true/false, provide modifier, case studies, and Internet-based exercises, were added to reinforce best practices and enrich learning and teaching experience.
Additional features and benefits of this AMA modifier coding guide:
- Fully updated for 2020 code set: CPT, HCPCS, ICD-10-CM and Medicare RBRVS code sets (RVU updates)
- CPT Evaluation & Management office or outpatient visit codes, descriptors, and coding guidance
- Clinical examples used throughout every chapter for every modifier to show how a modifier should be reported and the rationale for using each modifier.
- New CPT and HCPCS modifiers (includes code-set changes in an electronic Addendum, available Spring 2021)
- New logic trees in Appendix C
- Summary review of modifier usage checklist at the end of each chapter
- The modifier's complete definition, therefore users won't need to search for the modifier's definition in the CPT code book.
- HCPCS- codes and reporting needs.
- CPT- guideline and exceptions for the modifier in terms of its history and evolution (and its proper usage and by whom.
- CMS- guideline and exceptions for the modifier in terms of history and evolution and its proper usage and by whom.
- NCCI- guideline and exceptions for the modifier, if applicable, in terms of its proper usage and by whom.
- Third-party payer- guideline and exceptions for the modifier, if available and applicable, in terms of its proper usage and by whom.
Additional educational tools are included:
- Advice/Alert Note
- Coding Tips, Third-Party Coding Tips, CMS Coding Tips, Documentation Alert Tip
- 30 review exercises for each chapter to test understanding and application of content, including multiple choice, true/false, fill in blanks, case studies, and internet-based exercises
- Definitions of key terms
- Instructor materials, including PowerPoint slides, test bank, and instructor manual
CPT is a registered trademark of the American Medical Association.