November 6, 2023
The following policies received their Annual Review with no changes:
The following policies received their Annual Review with the updates noted below:
Modifier 33 – Preventive Services
In the Policy section added the new second paragraph. In the third paragraph, indicated that appending modifier 33 to a code is not a guarantee that the service will be processed as a preventive service. In the last paragraph, added a code example of an inherently preventive procedure.
Modifier 59 – Distinct Procedural Service
In the Policy section, added clarification to the sub-bullets in paragraph three and created a new section “Codes/Coding Guidelines” which includes full descriptions of the modifiers referenced in the policy.
Modifier 62 – Two Surgeons
In the Policy section, further clarification was added to the first paragraph for correct usage of modifier 62. In the sixth paragraph, indicated that when a co-surgery has been identified, all associated surgeon claims must be submitted with the same procedure code and modifier 62. In the eighth paragraph, indicated that each surgeon’s operative notes must identify the other co-surgeon.
Modifier NU – New DME Equipment and Modifier NR – New DME Equipment When Rented
In the Policy section, expanded upon how replacement DME is to be coded. Added the last paragraph which describes the three types of DME categories and included a link to the list of codes.
Modifier RR – Durable Medical Equipment (DME) Rental, Modifier KR – Rental item-partial month and Modifier LL – Lease/Rental
In the Policy section, in the second paragraph, added the last sentence to indicate how to bill a rental period if the dates are not continuous. In the fifth and sixth paragraphs, expanded on the correct coding for replacement DME by using modifier RA. Added the last paragraph which describes the three types of DME categories and included a link to the list of codes.
Place of Service Codes
Revised the code descriptions for the bulleted codes in the third paragraph. Added new Place of Service (POS) code 27-Outreach Site/Street effective October 1, 2023.
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