Tip: Keep track of new modifiers
APCs Insider, March 29, 2013
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CMS added two new modifiers to the anatomical modifiers that may be used under appropriate clinical circumstances to bypass an NCCI edit as part of the January update to OPPS:
- LM, Left main coronary artery
- RI, Ramus intermedius coronary artery
CMS also added two additional modifiers that coders can use to override an NCCI edit, when appropriate:
- 24, Unrelated E/M service by the same physician during a postoperative period
- 57, Decision for surgery
In addition, CMS added seven new modifiers for therapy and patient conditions:
- CH, 0% impaired, limited, or restricted
- CI, At least 1% but less than 20% impaired, limited, or restricted
- CJ, At least 20% but less than 40% impaired, limited, or restricted
- CK, At least 40% but less than 60% impaired, limited, or restricted
- CL ,At least 60% but less than 80% impaired, limited, or restricted
- CM, At least 80% but less than 100% impaired, limited, or restricted
- CN ,100% impaired, limited, or restricted
The tip is adapted from “CMS adds significant number of new codes” in the March Briefings on APCs.
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