Question:

Do modifiers ever replace a CPT® or HCPCS code?

Answer:

It is important to always remember that modifiers do not replace a CPT or HCPCS code, but are used to add clarity to the actual studies performed. Ask yourself the following questions regarding modifier usage. If you answer “yes” to the question, then it is appropriate to use the applicable modifier.

  • Will the modifier add more information regarding the anatomic site of the procedure?
  • Will the modifier help to eliminate the appearance of duplicate billing?
  • Would a modifier help to eliminate the appearance of unbundling?
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