Most of the new modifiers went into effect Jan. 1, but one new modifier — modifier -CS — has an effective retroactive date of April 20, 2010.
The description for -CS is: “Item or service related, in whole or in part, to an illness, injury, or condition that was caused by or exacerbated by the effects, direct or indirect, of the 2010 oil spill in the Gulf of Mexico, including but not limited to subsequent clean-up activities.”
Here are the 12 new modifiers which went into effect Jan. 1 and their descriptions:
-AY: Item or service furnished to a patient that is not for the treatment of ESRD
-AZ: Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment
-DA: Oral health assessment by a licensed health professional other than a dentist
-GU: Waiver of liability statement issued as required by payer policy, routine notice
-NB: Nebulizer system, any type, FDA-cleared for use with specific drug
-PT: Colorectal cancer screening test; converted to diagnostic test or other procedure.
The other six new modifiers — modifiers -4P, -4Q, -4R, -4S, -4T and -4U — are genetic testing code modifiers.
CMS also extended the use of modifier -FB. Providers report -FB when they report replacement of an implanted device with a device for which they incurred no cost or when they are replacing an implanted device with a device for which they received a credit in the amount of the cost of the replaced device. -FB is now extended to nuclear medicine procedures when the associated diagnostic radiopharmaceutical is obtained at no cost to the provider.
Source: CMS. View the January 2011 Integrated Outpatient Code Editor (pdf).
The information provided should be utilized for educational purposes only. Please consult with your billing and coding expert. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.
Read more about modifiers:
– Documentation Tips for CPT 2011 Digestive System Modifier Revisions and Additions
– 5 Changes to CPT Codes in 2011
– ASC Coding Guidance: Modifier -73 and -74 — Know the Difference
