Skip to main content

CPT Modifier 1P

Description for 1P:
Medical reasons

Guidelines for 1P Modifier:
In general, PQRI quality measures consist of a numerator and a denominator that permit the calculation of the percentage of a defined patient population that receive a particular process of care or achieve a particular outcome.
  • Where a patient falls in the denominator population but specifications define circumstances in which a patient may be excluded from the measure’s denominator population, CPT Category II code modifiers 1P, 2P, and 3P are available to describe medical, patient, or system reasons, respectively, for such exclusion
  • CPT modifier 1P: the quality measure was not applied due to medical reasons
  • This modifier is only valid with some measures
  • This modifier may only be reported with the CPT Category II codes for quality measures. It does not apply to HCPCS codes for quality measures.
  • Refer to each individual quality measure for specific indications for this modifier

Comments

Post a Comment

Popular posts from this blog

What is QMB / MQMB stands for?

In Medical billing or Healthcare industry The term QMB stands for Qualified Medicare Beneficiary & MQMB stands for Medicare Qualified Medicare Beneficiary. The term "QMB" or "MQMB" on the form indicates the client is a Qualified Medicare  Beneficiary (QMB) or a Medicaid Qualified Medicare Beneficiary (MQMB). The Medicare Catastrophic Coverage Act of 1988 requires Medicare premiums, deductibles, and coinsurance payments to be paid for individuals who meet the following criteria:  Important: Clients limited to QMB are not eligible for THSteps or THSteps-CCP Medicaid benefits.  Note: Clients eligible for STAR+PLUS who have Medicare and Medicaid are MQMBs. Medicaid reimburses for the coinsurance and deductibles as well as Medicaid-only services for the MQMB client. QMBs do not receive Medicaid benefits other than Medicare deductible and coinsurance liabilities. MQMBs do qualify for Medicaid benefits not covered by Medicare in addition
7 comments
Read more

Rejection Procedure note qualifier is missing

  Need to check the Charges tab and double click on the Procedure Code line to open up the Charge Entry window. There is a Notes section on the right hand side. If there is a note typed, we need to select the type.   Need to select field and select the appropriate type of note you are sending.   Save the changes made   Check all the procedure if submitted many procedure.   Save the visit again and submit the claim.
Post a Comment
Read more

Mastering the 'Tell Me About Yourself' Interview Question: Best Tips and Examples

In a job interview, the "Tell me about yourself" question is often asked early on and is an opportunity to make a positive first impression. The key is to provide a comprehensive response that highlights your qualifications and aligns with the job you're applying for. Here's a structured approach to crafting the best answer: Start with a Brief Personal Introduction: Begin by mentioning your name and your current or most recent role, if applicable. For example, "I'm [Your Name], and I'm currently working as a Sr AR Specialist at XYZ Company." Provide a Summary of Your Professional Background: Offer a concise overview of your professional journey, emphasizing the experiences and skills most relevant to the position you're interviewing for. You can mention your years of experience, notable career achievements, and areas of expertise. Highlight Relevant Achievements: Share specific accomplishmen
Post a Comment
Read more