Section title: Requests for Interpretation
RFI #
2490
Using HCPCS Modifiers for HIPPS codes
Description

Could you please clarify would be a compliant with guide to use modifiers from one code system, for example, HCPCS, for codes from other code system (HIPPS)?

RFI Response

It is not within X12's purview to provide billing directions.  The intent of the instructions in version 005010 is for the provider to follow the directions for use of the applicable code set from the maintainers of those code sets and any additional supporting documentation referred to by the maintainer.  The appropriate modifier should be used based on the code set maintainer's instructions for billing that code.

DOCUMENT ID
005010X223A2