An Introduction to CPT Coding: Modifiers

Outline:

Section 1: Introduction

About This Course

Learning Objectives

Section 2: Overview of Modifiers

What Are Modifiers?

Categories of Modifiers

Types of Modifiers

Use of Modifiers

NCCI-Associated Modifiers

Hospital Use of Modifiers

Professional and Technical Components

Modifier Examples: 26 and TC

Review

Section 3: Anatomical Modifiers

Anatomical Modifiers

Left, Right, and Bilateral Modifiers

Laterality Modifier Use 

Review

Section 4: Anesthesia Modifiers

Anesthesia Modifiers

Commonly Used Anesthesia Modifiers

Common Anesthesia CPT Modifiers 

Review

Section 5: E/M Modifiers

E/M Modifiers

E/M and Surgical Modifiers

Other E/M Modifiers

Procedures With E/M Codes

Review

Section 6: Surgical Modifiers

Surgical Modifiers

Hospital Outpatient Surgical Modifiers

Global Surgical Procedures

Co-Surgery and Surgical Teams

Surgical Procedure Modifiers

Review

Section 7: Conclusion

Course Summary

Course Contributor(s)

Resources

References

Sarah is a Subject Matter Expert/Writer for Relias's Revenue Cycle and Coding online education. Sarah is credentialed by AHIMA as a Certified Coding Specialist (CCS) and Certified Coding Specialist Physician-based (CCS-P), as well as an approved ICD-10-CM/PCS Trainer. She is also credentialed by AAPC as a Certified Professional Coding Instructor (CPC-I), a certified coder of physician/professional (CPC) and outpatient hospital services (COC), and a Certified Risk Adjustment Coder (CRC), with specialty certification in Evaluation and Management Services (CEMC). Sarah has extensive experience in both professional and facility ICD-10-CM/PCS, CPT and HCPCS coding, auditing, and revenue cycle management and as an educator of hospital and professional medical coding curriculum. She has served as Director of Physician Billing and Reimbursement for a regional health system, Manager of Coding and Compliance for a hospital and cancer center, and Business Manager of Physician Practices at a teaching hospital, as well as a coding auditor and consultant. Sarah has also authored coding textbooks and instructional resources.

Disclosure: Sarah A. Serling, CCS, CPC, CRC, COC, CCS-P, CEMC, CPC-I, ICD-10-CM/PCS Trainer has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.

Andrei is a healthcare coding analyst in the CPT Education and Information Services Department at the American Medical Association, a staff writer for CPT Assistant, and a contributing author of the Principles of CPT Coding textbook. He has been a Registered Health Information Technician since 2009 and an active AHIMA member. He has gathered experience and developed skills by working in health insurance, at third-party payers, and in top-ranked national health care organizations. He completed an AAS in Health Information Technology from DeVry University in 2008 and a BS in Biology from Georgia Gwinnett College in 2015. In his spare time Andrei enjoys traveling, reading, playing the piano and the pipe organ.

Disclosure: Andrei Besleaga, BS, RHIT has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.

Arletrice is a senior healthcare coding analyst in the CPT Education and Information Services Department and staff writer for CPT Assistant. She supports and assists with other department projects on an as-needed basis, and she is also a contributing author of the Principles of CPT Coding. She has been with the AMA for over 14 years. She has been an educator since 2002 in health information technology (HIT) and is currently a health care administration adjunct instructor at an online university. She earned a BS in Health Information Administration from the University of Illinois at Chicago, IL, and a Masters of Healthcare Administration from the University of Phoenix, AZ. She is also certified as a registered health information administrator from the American Health Information Management Association (AHIMA), as well as an AHIMA-approved ICD-10 CM/ PCS trainer.

Disclosure: Arletrice A. Watkins, MHA, RHIA has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.