Miss. Code. tit. 20, pt. 2, MODIFIER AND CODE RULES - MODIFIER AND CODE RULES
- § 20-2-I - MODIFIERS FOR CPT CODES, version 8
- § 20-2-II - MODIFIERS APPROVED FOR AMBULATORY SURGERY CENTER (ASC) AND HOSPITAL OUTPATIENT USE, version 8
- § 20-2-III - MODIFIERS FOR HCPCS CODES, version 7
- § 20-2-IV - PROCEDURE CODE EXCEPTIONS, version 6
This section of the Mississippi Workers' Compensation Medical Fee Schedule includes a complete listing of appropriate modifiers for use with CPT and HCPCS codes..
A. Modifiers
must be used by providers to identify procedures or services that are modified
due to specific circumstances.
B.
When modifier 22 is used to report an increased service, a report explaining
the medical necessity of the situation must be submitted with the claim to the
payer. It is not appropriate to use modifier 22 for routine billing. When
appropriate, the Mississippi Workers' Compensation Medical Fee Schedule
reimbursement for modifier 22 is one hundred twenty percent (120%) of the
maximum reimbursement allowance.
C.
The use of modifiers does not imply or guarantee that a provider will receive
reimbursement as billed. Reimbursement for a modified service or procedure is
based on documentation of medical necessity and determined on a case-by-case
basis.
D. Modifiers allow health
care providers to indicate that a service was altered in some way from the
stated description without actually changing the definition of the
service.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.