As you are now well aware, modifiers are a double-edged sword in coding. By correct coding principles, they serve to alert a payer that a procedure or service has been altered or is special in some way. New modifiers have been created to improve coding accuracy and help avoid billing problems, but there is the rub. Some carriers do not recognize modifiers, and that is where the Health Care Financing Administration (HCFA) plays a huge role in our otherwise non-Medicare world.

As reported previously, this would have allowed a physician to bill appropriately when a procedure or service is more difficult because of the size of the patient or a previously altered surgical field (prior surgeries or radiation therapy). However, HCFA has made a payment policy not to reimburse for the modifier -60, determining that the definition of which codes it would be billed with is too loose. Although some...

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