Transcription of MODIFIERS – Professional Claims
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MODIFIERS – Professional Claims
Effective 01/07/03-10/15/04. MODIFIERS Professional Claims BlueCross and BlueShield of Texas/HMO Blue Texas accepts all valid CPT and HCPCS. MODIFIERS into the Claims processing systems. The following MODIFIERS have logic associated with them that might impact the claim . _____. Modifier 22: Denotes an unusual procedural service. Should only be submitted on surgical procedure codes along with supporting documentation to justify the unusual service. Modifier 25: Denotes a significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service. Should only be submitted on an evaluation and management code, and medical records should reflect the significant, separately identifiable service. Modifier 50: Denotes a bilateral procedure. Should be submitted only for those surgical procedures that can be performed bilaterally. See Multiple Surgery document or Surgery Introduction, in the Medical Policy Manual for more information on bilateral procedures.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
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