When billing a procedure, which practice is allowed to indicate differences from the standard code?

• A. Using ICD-10 codes instead
• B. Omitting modifiers
• C. Prefixing with EX
• D. Using two-digit CPT modifiers

Answer: (D)

Modifiers attached to CPT procedure codes are the way to show differences from the standard code. These two-character codes are added to the procedure code to convey that the service was performed in a way that changes its billing or requires separate consideration (for example, a professional vs. technical component, a distinct or bilateral service, or a different technique). By applying the appropriate modifier, you communicate exactly how the procedure differed from the standard description, which affects reimbursement and payer review. Using ICD-10 codes would only describe the diagnosis, not modify the procedure code. Omitting modifiers hides the variation, and prefixing with EX isn’t a recognized method for signaling differences. So, the correct approach is to use the appropriate two-digit (two-character) CPT modifiers to indicate any differences.