Expert Oncology Billing Services

Modifier 25

Significant, separately identifiable E/M service performed on the same day as another procedure, ensuring accurate billing and proper reimbursement.

Modifier 59

ndicates a distinct procedural service performed separately from others on the same day, ensuring proper reimbursement for each service provided.

Modifier 51

Used when multiple procedures are performed in one session; the primary procedure gets full reimbursement, while additional ones may be reduced.

Modifier 76

Identifies a repeat procedure performed by the same physician, typically when the procedure needs to be done more than once in the same visit.

Modifier 57

Used when a decision for major surgery is made during an evaluation and management (E/M) service, indicating that surgery is planned afterward.

Modifier 22

Indicates increased procedural services, where a procedure takes more time or effort than usual, often used for complex oncology surgeries or treatments.

Modifier 33

Applies to preventive services, including cancer screenings like mammograms or colonoscopies, marking them as preventive rather than diagnostic procedures.

Modifier 90

Refers to laboratory tests or services performed by an outside laboratory, commonly used in oncology for specialized lab tests not done within the practice.

Modifier 50

Used when a bilateral procedure is performed, meaning both sides of the body are treated, such as bilateral mastectomies or other surgeries.