Does Your Staff Find the Hyphen Regulations Confusing?

The hyphenated codings have been removed from coding alerts. The American Medical Association has removed the hyphen from all coding manuals and the CPT Assistant. However even though the hyphen is no longer used in the manuals, whether or not your staff chooses to use it in their medical coding is solely up to them. It will not affect how your medical billing claims are handled.

Initially, the medical billing modifier hyphen was used in AMA publications for formatting purposes. It was supposed to ensure that people didn’t confuse the modifier with the rest of the current procedural terminology code. It was also to let people know that the number following the hyphen would be a medical billing modifier code.

In the case of using modifiers, such as 25, with a procedural code, the hyphens will still be used. An example would be 99202-25 (Office or other outpatient visit for the evaluation and management of a new patient; significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service).

Even though your medical billing will not have a modifier hyphen, it is important to still include it in your written correspondence. The hyphen accentuates the modifier and lets the payer know that you intended to add extra number in medical billing documentation. As missing modifiers is a problem with many insurers, anything to accentuate them is a plus.

The reports that this change will probably affect the way you do your medical billing are not accurate. On the CMS-1500 forms, and on electronic claims, there is a section for the CPT code and a completely separate section for the modifier. There are currently no plans to change this form.

View all Articles by: Melissa Clark, CCS-P