This modifier is used when we need to bill Medicare as a non-covered service.
What is GY?
100
The Privacy Rule was published as a part of this set of governmental regulations.
What is HIPAA?
Health Insurance Portability and Accountability Act.
100
When used by an EMT, this term refers to a patient being capable of walking.
What is ambulatory?
100
This is the only level of service that can be billed if the crewmembers, or the ambulance service itself, is licensed at the EMT-Basic level of service.
What is BLS?
100
Many of us in the office are well on our way to contracting this disease, which affects how the body uses and regulates levels of blood glucose.
What is diabetes?
200
When a beneficiary passes away after the ambulance is dispatched, but before any transport occurs, the claim should be billed with this modifier.
What is QL?
200
This refers to individually identifiable health information, such as demographic, financial, insurance or health-care related information.
What is Protected Health Information (or PHI)?
200
This procedure involves passing a thin, flexible tube into the right or left side of the heart.
What is cardiac catheterization?
Cardiac cath.
200
This level of service would be billed when an appropriately licensed crew responds to transfer a patient from one hospital to another for long term acute care while monitoring cardiac rhythm and an IV of Normal Saline.
What is ALS Non-Emergency?
200
Common complications arising from this affliction include aphasia, dysphagia, cognitive impairments and hemiplegia.
What is a stroke (CVA)?
300
This modifier would be used when a patient covered by Wisconsin Medicaid is transported from a Doctor's Office to a Hospital on the 2nd trip of the day.
What is U2PH?
300
DAILY DOUBLE!!
As long as reasonable safeguards are in place, this is the only disclosure allowed by the Privacy Rule where information is disclosed to an unauthorized individual.
What is an Incidental Disclosure?
300
This refers to a group of diseases, including emphysema and chronic bronchitis, that block airflow and cause breathing difficulties.
What is COPD?
Chronic Obstructive Pulmonary Disease.
300
This level of service would be billed when an appropriately licensed crew responds to transfer a patient from one hospital to another while using a BVM ventilate the patient through an ET tube.
What is ALS 2?
300
CMS defines this term as being unable to ambulate, unable to get up without assistance and unable to sit in a chair or a wheelchair.
What is bed confined?
400
A patient under a Medicare-covered hospice stay accidently burns herself with scalding hot coffee. What modifier should go on the claim?
What is GW?
400
This principle refers to the requirement that a Covered Entity must make reasonable efforts to use, disclose and request only the minimum amount of information needed to fulfill the intended purpose of the use, disclosure or request.
What is the "Minimum Necessary" principle?
400
This section of the spine is formed by the first 7 vertebrae located at the top of the spine.
What is the cervical spine (C-Spine)?
400
When the QL modifier is used, Medicare or Medicaid will only reimburse at this level of service, regardless of the service that was actually provided.
What is the BLS Emergency rate?
400
This condition is defined as a narrowing of the open spaces within your spine, usually in the neck and lower back, putting pressure on the spinal cord and the nerves travelling through the spinal column.
What is spinal stenosis?
500
If you were to combine the modifiers signifying a physician's office, the site of transfer between modes of ambulance transport, and a hospital-based dialysis facility, you would come up with this animal.
What is a PIG?
500
Also known as the TPO exceptions, a covered entity is allowed by the Privacy Rule to release information without authorization from the patient to a health care provider engaging in one of these three activities.
What is Treatment, Payment and Health Care Operations?
500
This device can be used to transfer an immobile or even obese patient from one stretcher to another with minimal exertion on the part of the caregivers.
What is a hoyer lift?
500
In Wisconsin, an ambulance supplier is only entitled to the highest level of base rate reimbursement when the caregiver is licensed at this level.
What is Critical Care Paramedic?
500
People diagnosed with this condition have a lack of muscle coordination due to effects on the nervous system controlling movement and balance.