Ama Policy

CPT Modifiers D-70.959

Payment Edits

AMA policy is that a CPT code representing a service or procedure that is covered and paid for separately should also be paid for when performed at the same time as another service or procedure, unless CPT coding guidelines specifically direct users not to report the service or procedure (i.e., separate procedure codes), and that if the service or procedure is reimbursed zero dollars, or otherwise not recognized by an insurer, the service or procedure should be considered uncovered and thus billable to the patient.

Policy Timeline

BOT Action in response to referred for decision Res. 828, I-05Modified: CMS Rep. 1, A-15