IMPORTANT NOTE ABOUT THIS REIMBURSEMENT …

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1 Modifier AT REIMBURSEMENT Policy Policy Number 0050 Annual Approval Date 04/2020 Approved By Optum REIMBURSEMENT and Technology Committee Optum Quality and Improvement Committee IMPORTANT NOTE ABOUT this REIMBURSEMENT POLICY You are responsible for submission of accurate claims. this REIMBURSEMENT policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. Optum REIMBURSEMENT policies may use Current Procedural Terminology (CPT *), Centers for Medicare and Medicaid Services (CMS) or other coding guidelines. References to CPT or other sources are for definitional purposes only and do not imply any right to REIMBURSEMENT .

2 A modifier provides the means by which the reporting health care practitioner can indicate that a CPT descriptor code (service or procedure), which has been performed, has been altered by a specific circumstance or in some way without changing the definition of the CPT code.

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