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Since the outbreak of Covid telemedicine has become the norm to for all doctor’s and specialist. The fear of Covid exposure in doctor’s office and hospitals have led to the use of telemedicine. The use of telemedicine is not just for rural areas that have limited access to doctor’s but to metroplexes also. Telemedicine is used in specialty clinics and by using zoom doctor’s can make accurate diagnosis without physically laying hands on a patient. Technology has given doctor’s less crowded offices and with little wait time for patients. Patients don’t have to plan their whole day waiting in doctor’s offices for hours. The down side is that sometimes doctor’s can miss something by not physically examining a patient. A physical examination can help a doctor locate and physically see where a problem or concern that a patient has.
Modifiers are level one two digit codes of alpha and or numeric characters (Vines et al., 2017).This information aids in the description of procedural codes without changing how it is defined (Vines et al., 2017). The additional coding data from these modifiers can be applied to Medicare claims and the Health and Common Procedure Coding Systems (Vines et al., 2017). By using the correct modifiers, coding errors that can lead to fraud, non-compliance, or abuse of government services will be avoided (Vines et al., 2017).
There are numerous reasons for the use of modifiers including:
If it is mandated by third-party payers
If a procedure contains a technical and professional component
When supplementary services were performed
If services were provided on bilateral sites
When a service provided more than once
Upon the occurrence of uncommon events
When there is a reduction or extended services provided
When the same provider provided multiple services in the same session
When according to the doctor’s judgment, some procedures or services may be canceled or reduced.
Reporting extend provided services by surgeons
The delivery of services in more than one location by other healthcare professionals or more than one physician (Vines et al., 2017).
I am a nurse in the Allegheny Health system in Pittsburgh, Pennsylvania. This hospital system is a renowned Bariatric center in Western Pennsylvania. Bariatric gastric Roux-en-Y bypass or gastric sleeve bypass surgeries are frequently performed on morbidly obese individuals (ASMBS, 2021). When diet and exercise have been unsuccessful bariatric surgery is an effective option (ASMBS, 2021). Gastric bypass procedures must meet specific pre-authorization criteria to be considered beneficial and surgically necessary for reimbursement purposes by Medicare or private insurance (ASMBS, 2021). These conditions include a letter of medical necessity, a Class 3 BMI greater than 40, or a BMI of 35-39.9 with health-related co-morbidities (ASMBS, 2021). Those who are morbidly obese have many other health-related conditions and many other components which require billing codes (ASMBS, 2021). These conditions include gastroesophageal reflux disease (GERD), obstructive sleep apnea (OSA), type 2 diabetes, depression, anxiety, infertility, hypercholesterolemia, cerebrovascular accident, heart disease, high blood pressure, and cancer (ASMBS, 2021).