Healthcare Regulatory 2008 Update

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Coding and Documentation 2008 Update

Presented by
Amper’s Healthcare Services Group

2008 Modifier Changes

Modifier Changes Effective 1/1/08

Modifier 22
- Will state for "increased procedural services"
  - Replacing "unusual procedural services"
  - When work required is substantially greater than usually required
  - Also states documentation must show that additional work was done & explain why the extra work was needed
Modifier 59 (Distinct Procedural Service)
- Description changed to remove any reference to "physician," replacing it with individual
  - Non-physician providers (NPP’s)
- Also states that documentation must support the use of this modifier
Modifier 78 (Return to OR)
- More detailed description
  - "Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period"
Modifier 92 – New Modifier
- Alternative Laboratory Platform Testing
  - Should be used when a lab service (such as HIV test codes 86701-86703) is done with a kit containing a single use, disposable chamber