Mississippi Administrative Code
Title 20 - Labor
Part 2 - Mississippi Workers' Compensation Medical Fee Schedule
MODIFIER AND CODE RULES
Current through March 14, 2024
This section of the Mississippi Workers' Compensation Medical Fee Schedule includes a complete listing of appropriate modifiers for use with CPT and HCPCS codes..
A. Modifiers must be used by providers to identify procedures or services that are modified due to specific circumstances.
B. When modifier 22 is used to report an increased service, a report explaining the medical necessity of the situation must be submitted with the claim to the payer. It is not appropriate to use modifier 22 for routine billing. When appropriate, the Mississippi Workers' Compensation Medical Fee Schedule reimbursement for modifier 22 is one hundred twenty percent (120%) of the maximum reimbursement allowance.
C. The use of modifiers does not imply or guarantee that a provider will receive reimbursement as billed. Reimbursement for a modified service or procedure is based on documentation of medical necessity and determined on a case-by-case basis.
D. Modifiers allow health care providers to indicate that a service was altered in some way from the stated description without actually changing the definition of the service.
