I need help with this assignment.
Apply the appropriate Level II HCPCS code modifier for each of the following examples. Explain your rationale for each selection.
a. Sutures, upper right eyelid
b. MD calls ambulance to transport a patient from his office to the hospital for respiratory issues
c. Diagnostic mammogram, left breast
d. Cortisone 10 mg injection, right shoulder
e. Electric wheelchair that is not medically necessary
f. Intravenous catheter line (PICC), right arm
g. Laboratory processing of cytology specimens
h. Splint, right hand thumb
i. Prosthetic hip replacement, left side
j. Angiography, Right coronary artery
How would you like us to help you with this assignment?
I got the code modifier for each one down but i am not understanding how to give the rationale my intructor needs.
Your instructor wants to know why you chose each code modifier.
For instance, why did you choose the code modifier for "Sutures, upper right eyelid?"
ok when it is put that way I udnderstand it better. thank you very much Ms. Sue, have a good night.
You're very welcome, Amanda. You have a good night, too.
To apply the appropriate Level II HCPCS code modifier for each of the examples provided, you need to understand the purpose and meaning of HCPCS code modifiers. HCPCS (Healthcare Common Procedure Coding System) modifiers are used to provide additional information about a procedure or service being provided.
a. For sutures on the upper right eyelid, the appropriate modifier would be modifier -RT. This modifier is used to indicate that the procedure was performed on the right side of the body.
b. When a medical professional calls an ambulance to transport a patient from their office to the hospital for respiratory issues, the appropriate modifier would be modifier -ET. This modifier indicates that the service was provided for emergency transport.
c. For a diagnostic mammogram on the left breast, there is no specific HCPCS modifier required unless there are special circumstances or requirements for the procedure.
d. For a cortisone 10 mg injection on the right shoulder, the appropriate modifier would be modifier -RT. This modifier indicates that the procedure was performed on the right side of the body.
e. For an electric wheelchair that is not medically necessary, the appropriate modifier would be -GA. This modifier indicates that the procedure/service was known by the performing physician and the patient to be a non-covered service.
f. For an intravenous catheter line (PICC) on the right arm, the appropriate modifier would be modifier -RT. This modifier is used to indicate that the procedure was performed on the right side of the body.
g. For laboratory processing of cytology specimens, there is no specific HCPCS modifier required unless there are special circumstances or requirements for the procedure.
h. For a splint on the right hand thumb, the appropriate modifier would be modifier -RT. This modifier indicates that the procedure was performed on the right side of the body.
i. For a prosthetic hip replacement on the left side, the appropriate modifier would be modifier -LT. This modifier indicates that the procedure was performed on the left side of the body.
j. For angiography on the right coronary artery, the appropriate modifier would be modifier -RT. This modifier indicates that the procedure was performed on the right side of the body.
When selecting the appropriate modifiers, it is important to consult the specific guidelines provided by the Centers for Medicare and Medicaid Services (CMS), the insurer, or any other relevant coding guidelines. Additionally, it is crucial to document and support the use of modifiers in the medical record.