708.452.1111, ext 11 Anthony@gisbilling.com


To decrease the National Paid Claims error rate, Medicare encourages all practitioners to become familiar with National Correct Coding initiative where they can learn all about the Physician Fee Schedule Data Base and clarify modifier usage.

Learning to use the correct modifier will result in fewer denials.

Modifiers fall into a variety of categories:

  • Reimbursement
  • Informational
  • Minor procedure
  • Major procedure
  • Day prior to surgery day
  • Surgery day
  • 90 days immediately following surgery day
  • Post-operative days
  • Dressing change
  • Suture and staple removal
  • Bedside minor procedure
  • Initial consultation
  • Evaluation determine need for surgery
  • Services of other physical services not included in the Global Surgical Package
  • More extensive procedure required
  • Diagnostic tests and procedures
  • Non-related surgical procedure
  • Immunotherapy management


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