what is the on call physician modifier
There is no modifier 46.
Modifier -55 is used in medical billing to indicate that a physician has provided postoperative management for a surgical procedure performed by another provider. It highlights that the surgeon who performed the procedure is not responsible for the follow-up care, which is being managed by a different physician. This modifier ensures proper reimbursement for the postoperative care rendered while clarifying the roles of the involved healthcare providers.
-54
47
The modifier that indicates that only the professional portion of a service was performed is typically the "26" modifier. This modifier is used to signify that the professional component of a service, such as a medical procedure or diagnostic test, was provided separately from the technical component. It helps clarify billing and reimbursement by distinguishing between the services provided by the physician and those performed by other entities or facilities.
Modifier 26 indicate the professional component of a procedure in Current Procedural Terminology (CPT), which is used for medical billing.
CPT modifier -22 is used to indicate that a procedure was more complex or took significantly more time than usual, warranting additional reimbursement. It helps to convey the increased effort required by the physician or healthcare provider beyond the standard expectations for that procedure. When submitting claims with this modifier, providers must include documentation to support the need for the modifier and the reasons for the increased complexity.
In medical coding, modifier -47 indicates that a procedure was performed with anesthesia. It is used to signify that the provider administered anesthesia for a surgical procedure, highlighting that the anesthesia was a significant part of the service. This modifier helps ensure appropriate reimbursement and documentation for anesthesia-related services.
When billing for a comparison study X-ray, the modifier commonly used is modifier -TC (Technical Component). This modifier indicates that the claim is for the technical component of the X-ray service, often in cases where previous images are compared to current studies. Additionally, if the comparison involves a prior study, modifier -76 (Repeat Procedure by Same Physician) may also be applicable. It's important to follow specific payer guidelines for proper billing.
modifier -51
Modifier -90 should be reported when a service or procedure is performed by a physician or qualified healthcare professional but the interpretation or analysis of the results is done by a different provider. This is commonly used for laboratory tests or diagnostic imaging where the original provider submits the claim for the test, while the interpreting physician submits a separate claim using modifier -90 to indicate that they did not perform the test themselves. It helps ensure proper billing and clarity in the services rendered.
To be used when a resident sees the patient and the teaching physician in not present.