what modifier is used to report an evaluation and management service mandated by a court order
Modifier – equally the proper name implies a modifier will modify a service / procedure or an item nether certain circumstances for appropriate reimbursement.
Modifiers may add information or change the description co-ordinate to the dr. documentation to requite more specificity for the service or procedure rendered.
Appending of an appropriate modifier volition finer respond to reimbursement.
Modifiers are two digit codes and are categorized into ii levels:
Level I CPT Modifiers: Normally known as CPT Modifiers and consists of two numeric digits and are updated annually by AMA – American Medical Clan.
Level II HCPCS Modifiers: Normally known as HCPCS Modifiers and consists of two digits (Alpha / Alphanumeric characters) in the sequence AA through VP. These modifiers are annually updated by CMS – Centres for Medicare and Medicaid Services.
Both the in a higher place levels of Modifiers are recognized nationally.
Level I CPT Modifiers
CPT Modifier 21
What Is A CPT 21 Modifier? Prolonged Evaluation and Management Services (Deleted, please use CPT 99354- CPT 99359).
Usage and Reimbursement CPT Modifier 21: CPT Modifier 21 is used when the face-to-face service provided is prolonged or otherwise greater than usually required for the highest level of evaluation and management (E&M) service within a.. Read more..
CPT Modifier 22
What Is A CPT 22 Modifier?: Increased Procedural Services.
Usage and Reimbursement of CPT Modifier 22: As the description implies this modifier should not be reported with an Evaluation and Direction services.
Information technology should only be reported with procedure codes that have a global period of , 10, 90 days.. Read more than..
CPT Modifier 23
What Is A 23 Modifier?: Unusual Anesthesia.
Usage and Reimbursement of CPT Modifier 23: Occasionally, a procedure, which usually requires either no anesthesia or local anesthesia, because of unusual circumstances must be washed nether general anesthesia.
This is considered.. Read more..
CPT Modifier 24
What Is A 24 Modifier? Unrelated Evaluation and Direction Service by the Same Physician during a Postoperative Period.
Usage and Reimbursement of CPT Modifier 24: Append CPT Modifier 24 to the E/M procedure code or eye exam. Use on an unrelated E/1000 service beginning the day afterward a process, when the E/M is performed by the aforementioned physician during.. Read more..
CPT Modifier 25
What Is A 25 Modifier?: Meaning, Separately Identifiable Evaluation and Direction Service by the Aforementioned Physician on the Same Day of the Procedure or Other Service.
Usage and Reimbursement of CPT Modifier 25: Physicians and Qualified Nonphysician practitioners (NPP) should use CPT Modifier 25 to designate a significant, separately identifiable Eastward/M service provided by the same dr./qualified.. Read more than..
CPT Modifier 26
What Is A 26 Modifier?: Professional person Component.
Usage and Reimbursement of CPT Modifier 26: CPT Modifier 26 identifies the md's or professional component of a 2-component (professional and technical) service.
The doctor component is reported separately when the.. Read more..
CPT Modifier 27
What Is A 27 Modifier?: Multiple Outpatient Hospital East/M Encounters on the Same Date.
Usage and Reimbursement of CPT Modifier 27: The CPT defines Modifier 27 as "multiple outpatient hospital evaluation and management encounters on the same date."
Utilize modifier modifier 27 when a patient receives multiple E/Thousand services performed.. Read more..
CPT Modifier 29
What Is A 29 Modifier?: Global procedures, those procedures where one provider is responsible for both the professional person and technical component.
Note: Modifier 29 has been deleted. If a provider is billing for a global service, no modifier is necessary.
CPT Modifier 32
What Is A 32 Modifier?: Mandated Services.
Usage and Reimbursement of CPT Modifier 32: CPT Modifier 32 should be used when services related to mandated consultation and / or related services such as confirmatory consultations and related diagnostic service (eg. third.. Read more..
CPT Modifier 33
What Is A 33 Modifier?: Preventive Service.
Usage and Reimbursement of CPT Modifier 33: When the master purpose of the service is the delivery of an bear witness-based service in accordance with a The states Preventive Services Task Force A or B rating in effect and other preventive.. Read more..
CPT Modifier 47
What Is A 47 Modifier? Anesthesia by Surgeon.
Usage and Reimbursement of CPT Modifier 47: CPT Modifier 47 is used to study regional or CPT code for full general anesthesia provided by the attending or assistant surgeon.
Add CPT Modifier 47 to the basic service. This does not include.. Read more..
CPT Modifier 50
What Is A 50 Modifier? Bilateral Process.
Usage and Reimbursement of CPT Modifier l: Bilateral services are procedures performed on both sides of the torso during the same operative session or on the same day.
Modifier 50 is not applicative to procedures.. Read more..
CPT Modifier 51
What Is A 51 Modifier?: Multiple Procedures.
Usage and Reimbursement of CPT Modifier 51: CPT Modifier 51 designates multiple procedures that are rendered at the same operative session or on the same day.
Modifier 51 (multiple procedures) must be used to signal instances when.. Read more..
CPT Modifier 52
What Is A 52 Modifier?: Reduced Services.
Usage and Reimbursement of CPT Modifier 52: Modifier 52 identifies situations where the md elects to reduce or eliminate a portion of a service or process.
Embrace letters or operative reports are not necessary when modifier 52 is.. Read more than..
CPT Modifier 53
What Is A 53 Modifier?: Discontinued Procedure.
Usage and Reimbursement of CPT Modifier 53: Nether certain circumstances, the md may elect to terminate a surgical or diagnostic procedure due to extenuating circumstances or those that threaten the well beingness of the.. Read more..
CPT Modifier 54
What Is A 54 Modifier?: Surgical Care But.
Usage and Reimbursement of CPT Modifier 54: Modifier 54 identifies when ane physician performs a surgical procedure and another provides preoperative and/or postoperative management.
The surgeon who performs the surgical procedure reports CPT Modifier 54. Submit CPT Modifier 54 only with.. Read more than..
CPT Modifier 55
What Is A 55 Modifier?: Postoperative Management Only.
Usage and Reimbursement of CPT Modifier 55: When i physician performed the postoperative management only modifier and another physician performed the surgical procedure, the postoperative component may be identified by adding Modifier 55.. Read More..
CPT Modifier 56
What Is A 56 Modifier?: Preoperative Direction Only.
Usage and Reimbursement of CPT Modifier 56: When one physician performed the preoperative care and evaluation and another md performed the surgical procedure, the preoperative component may be identified by adding Modifier 56 to.. Read more..
CPT Modifier 57
What Is A 57 Modifier?: Decision for Surgery.
Usage and Reimbursement of CPT Modifier 57: CPT Modifier 57 is used when the initial determination to perform a major surgical procedure is made during an E&M service provided the twenty-four hour period before or the day of a major surgery.
Modifier 57 replaces HCPCS Level II Modifier QI.. Read more..
CPT Modifier 58
What Is A 58 Modifier?: Staged or Related Procedure or Service past the Same Doc During the Postoperative Period.
Usage and Reimbursement of CPT Modifier 58: The Modifier 58 definition is explained equally the CPT Transmission every bit a "staged or related procedure or service by the same md during the postoperative period".
Modifier 58 may be used to bespeak that a procedure.. Read more than..
CPT Modifier 59
What Is A 59 Modifier?: Distinct Procedural Service.
Usage and Reimbursement of CPT Modifier 59: Modifier 59 is used to indicate a distinct procedural service.
The physician may demand to indicate that a procedure or service was distinct or independent from other services performed on the same day. This may.. Read more..
CPT Modifier 62
What Is A 62 Modifier?: Ii Surgeons.
CPT Modifier 63
What Is A 63 Modifier?: Process Performed on Infants less than 4kg.
CPT Modifier 66
What Is A 66 Modifier?: Surgical Team.
CPT Modifier 73
What Is A 73 Modifier?: Discontinued Outpatient Hospital/Convalescent Surgery Center (ASC) Procedure prior to the Administration of Anesthesia.
CPT Modifier 74
What Is A 74 Modifier?: Discontinued Outpatient Hospital/Convalescent Surgery Center (ASC) Procedure after Administration of Anesthesia.
CPT Modifier 76
What Is A 76 Modifier?: Repeat Procedure by Same Physician.
CPT Modifier 77
What Is A 77 Modifier?: Repeat Procedure by Another Medico.
For more than information about modifier 77, please refer to this commodity..
CPT Modifier 78
What Is A 78 Modifier?: Return to the Operating Room for a Related Procedure During the Postoperative Period.
CPT Modifier 79
What Is A 79 Modifier?: Unrelated Process or Service by the Aforementioned Medico During the Postoperative Period.
CPT Modifier eighty
What Is An 80 Modifier? Assistant Surgeon.
CPT Modifier 81
What Is An 81 Modifier? : Minimum Assistant Surgeon.
CPT Modifier 82
What Is An 82 Modifier? : Assistant Surgeon (when qualified resident surgeon not available).
CPT Modifier ninety
What Is A 90 Modifier? Reference (Exterior) Laboratory.
CPT Modifier 91
What Is A 91 Modifier? Echo Clinical Diagnostic Laboratory Examination.
CPT Modifier 92
What Is A 92 Modifier? : Alternative Laboratory Platform Testing.
CPT Modifier 96
What Is A 96 Modifier? : Habilitative Services.
Usage and Reimbursement of Modifier 96: When a service or procedure that may either be habilitative in nature or rehabilitative in nature is provided for habilitative purposes.
The dr. or other qualified healthcare professional may add Modifier 96 to.. Read more than..
CPT Modifier 97
What Is A 97 Modifier? : Rehabilitative Services.
Usage and Reimbursement of CPT Modifier 97: When a service or procedure that may exist either habilitative or rehabilitative in nature is provided for rehabilitative purposes.
The doc or other qualified healthcare professional may add modifier 97.. Read more than..
CPT Modifier 99
What Is A 99 Modifier? : Multiple Modifiers.
HCPCS Level II Modifiers
Modifier AA
What Is An AA Modifier? : Anesthesia services personally performed by anesthesiologist.
Modifier AD
What Is An Advertizing Modifier? : Medical supervision by a md: More 4 concurrent anesthesia procedures.
Modifier AE
What Is AN AE Modifier? : Registered Dietician.
Modifier AF
What Is An AF Modifier? : Specialty Physician.
Modifier AG
What Is An AG Modifier? : Principal Physician.
Modifier AH
What Is An AH Modifier? : Clinical Psychologist.
Modifier AI
What Is An AI 79 Modifier? : Principal Doctor of Record.
Modifier AJ
What Is An AJ Modifier? : Clinical Social Worker.
Modifier AK
What Is An AK Modifier? : Non Participating Medico.
Modifier AM
What Is An AM Modifier? : Physician, squad fellow member service.
Modifier AP
What Is An AP Modifier? : Determination of refractive state was non performed in the grade of diagnostic ophthalmological test.
Modifier AQ
What Is An AQ Modifier? : Service performed in a Health Professional Shortage Expanse.
Modifier AR
What Is An AR Modifier? Physician providing services in a physician scarcity area.
Modifier AS
What Is An As Modifier? : Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist services for assistant-at-surgery, not-team member.
Modifier AT
What Is An AT Modifier? : Acute handling (chiropractic claims).
Usage Of Modifier AT: This modifier should be used when reporting CPT 98940, CPT 98941, CPT 98942 or CPT 98943 for acute treatment.
Modifier AU
What Is An AU Modifier? : Particular furnished in conjunction with a urological, ostomy, or tracheostomy supply.
Usage of Modifier AU: Modifier AU is but applicable for the HCPCS codes: A4217 (Sterile water/saline, 500 ml), A4450 (Tape, nonwaterproof, per xviii.. Read more..
Modifier AV
What Is An AV Modifier? : Item furnished in conjunction with a prosthetic device, prosthetic or orthotic.
Usage of Modifier AU: Modifier AU is just applicable for the HCPCS codes; A4450 (Tape, nonwaterproof, per 18 sq in), A4452 (Tape, waterproof, per xviii.. Read more than..
Modifier AW
What Is An AW Modifier? : Item furnished in conjunction with a surgical dressing.
Usage of Modifier AW: Modifier AW is merely applicable for the HCPCS codes; A4450 (Tape, nonwaterproof, per 18 sq in), A4452 Tape, waterproof, per 18.. Read more..
Modifier AX
What Is An AX Modifier? : Item furnished in conjunction with dialysis services.
Modifier AY
What Is An AY Modifier? : Item or service furnished to an ESRD patient that is not for the treatment of ERSD.
Modifier AZ
Description of Modifier AZ: Physician providing a service in a dental Health Professional Shortage Area for the purpose of an Electronic Health Record Incentive Payment.
Modifier A1
What Is An A1 Modifier? : Dressing for one wound.
Modifier A2
What Is An A2 79 Modifier? : Dressing for 2 wounds.
Modifier A3
What Is An A3 Modifier? : Dressing for 3 wounds.
Modifier A4
What Is An A4 Modifier? : Dressing for four wounds.
Modifier A5
What Is An A5 Modifier? : Dressing for five wounds.
Modifier A6
What Is An A6 Modifier? : Dressing for six wounds.
Modifier A7
What Is An A7 Modifier? : Dressing for vii wounds.
Modifier A8
What Is An A8 Modifier? : Dressing for viii wounds.
Modifier A9
What Is An A9 Modifier? : Dressing for nine or more than wounds.
Modifier BA
What Is A BA Modifier? : Detail furnished in conjunction with parenteral enteral nutrition (PEN) services.
Modifier BL
What Is A BL Modifier? : Special Conquering of blood and blood products.
Modifier CA
What Is A CA Modifier? Process payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission.
Modifier CB
What Is A CB Modifier? : Services ordered past a dialysis facility physician as part of the ESRD beneficiary'south dialysis benefit.
Modifier CC
What Is A CC Modifier? : Process code modify- CARRIER Utilise ONLY –
Modifier can be used by carrier to indicate that the process lawmaking submitted was inverse either for administrative reasons or considering an incorrect code was filed.
Modifier CD
What Is A CD Modifier? :AMCC examination has been ordered by an ESRD facility or MCP dr. that is part of the composite rate and is not separately billable.
Modifier CE
What Is A CE Modifier? : AMCC tests has been ordered past an ESRD facility or MCP physician that is a blended rate test but is across the normal frequency covered under the rate and is separately reimbursable based on medical necessity.
Modifier CF
What Is A CF Modifier? : AMCC tests has been ordered by an ESRD facility or MCP doc that is not part of the composite charge per unit and is separately billable.
Reference: http://world wide web.cms.gov/MLNMattersArticles/downloads/MM6683.pdf
Modifier CH
What Is A CH Modifier? : 0 percent dumb, limited or.. Read more than..
Modifier CI
What Is A CI Modifier? : At least 1 percent but less than.. Read more..
Modifier CJ
What Is A CJ Modifier? At least twenty pct but less than.. Read more..
Modifier CK
What Is A CK Modifier? : At least 40 percentage just less.. Read more..
Modifier CL
What Is A CL Modifier? : At to the lowest degree threescore percentage but less.. Read more than..
Modifier CM
What Is A CM Modifier? : At to the lowest degree lxxx percent but less than.. Read more than..
Modifier CN
What Is A CN Modifier? : 100 percentage impaired, limited or.. Read more..
Reference: http://world wide web.cms.gov/Outreach-and-Educational activity/Outreach/NPC/Downloads/FunctionalReportingNPC.pdf
Modifier CM
What Is A CM Modifier? : Ending/Disaster Related.
Modifier CS
What Is A CS Modifier? : Detail or service related, in whole or in part, to an disease, injury, or condition that was caused past or exacerbated by the furnishings, straight or indirect, of the 2010 oil spill in the Gulf of United mexican states, including but not limited to subsequent clean-up activities.
Modifier DA
What Is A DA Modifier? : Oral wellness assessment past a licensed Health Professional other than a dentist.
Modifier EA
What Is An EA Modifier? : Erythropetic stimulating agent (ESA) administered to treat anemia due to anti-cancer chemotherapy.
Usage and Reimbursement of Modifier EA: The EA modifier should only be reported when the ESA is being given for anemia resulting from myelosuppressive anticancer chemotherapy in solid tumors, multiple myeloma, lymphoma, and.. Read more..
Modifier EB
What Is An EB Modifier? : Erythropetic stimulating agent (ESA) administered to treat anemia due to anti-cancer radiotherapy.
Usage and Reimbursement of Modifier EB: CMS EB uses this modifier to get together information to make up one's mind the prevalence and severity of anemia associated with cancer therapy.
The clinical and hematologic responses to the institution of antianemia therapy, and.. Read more than..
Modifier EC
What Is An EC Modifier? : Erythropetic stimulating agent (ESA) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy.
Usage and Reimbursement of Modifier EC: Modifier EC should but be reported for those covered indications outlined in the LCD for J0881 and J0885 where the anemia existence treated is non-chemo/radio induced.
FSCO has discovered that providers.. Read more..
Modifier ED
What Is An ED Modifier? : Hematocrit level has exceeded 39% (or Hemoglobin level has exceeded xiii.0 G/DL) for iii or more than consecutive billing cycles immediately prior to and including the current cycle.
Modifier EE
What Is An EE Modifier? : Hematocrit level has not exceeded 39% (or Hemoglobin level has not exceeded 13.0 Chiliad/DL) for iii or more consecutive billing cycles immediately prior to and including the electric current cycle.
Modifier E1
What Is An E1 Modifier? : Upper left, eyelid.
Modifier E2
What Is An E2 Modifier? : Lower left, eyelid.
Modifier E3
What Is An E3 Modifier? Upper right, eyelid.
Modifier E4
What Is An E4 Modifier? Lower right, eyelid.
Modifier EJ
What Is An EJ Modifier? Subsequent claims for a defined course of therapy, eastward.g., EPO, sodium hyaluronate, infliximab.
Modifier EM
What Is An EM Modifier? Emergency reserve supply (for ESRD benefit only).
Modifier ET
What Is An ET Modifier? Emergency handling – Apply to designate a dental process performed in an emergency state of affairs.
Modifier FA
What Is A FA Modifier? Left hand, thumb.
Modifier F1
What Is A F1 Modifier? Left hand, 2d digit.
Modifier F2
What Is A F2 Modifier? Left hand, 3rd digit.
Modifier F3
What Is A F3 Modifier? Left paw, quaternary digit.
Modifier F4
What Is A F4 Modifier? Left hand, fifth digit.
Modifier F5
What Is A F5 Modifier? Right hand, thumb.
Modifier F6
What Is A F6 Modifier? Right hand, second digit.
Modifier F7
What Is A F7 Modifier? Right paw, tertiary digit.
Modifier F8
What Is A F8 Modifier? Right mitt, quaternary digit.
Modifier F9
What Is A F9 Modifier? Right paw, fifth digit.
Modifier FB
What Is A FB Modifier? Detail provided without cost to provider, supplier or practitioner, or credit received for replaced device (examples, simply not limited to covered under warranty, replaced due to defect, gratis samples)
Modifier FC
What Is A FC Modifier? Partial credit received for replaced device
Modifier FY
What Is A FY Modifier? Designates imaging services that are X-rays taken using computed radiography.
Usage of Modifier FY: Beginning Jan 1, 2018, and including Calendar Years (CY) 2018-CY 2022, a payment reduction of seven pct applies to the technical component (and the technical component of the global fee) for computed radiography services.. Read more..
Modifier G1
What Is A G1 Modifier? Nearly contempo URR of less than.. Read more..
Modifier G2
What Is A G2 Modifier? Most recent URR of 60% to.. Read more..
Modifier G3
What Is A G3 Modifier? Almost recent URR of 65% to.. Read more..
Modifier G4
What Is A G4 Modifier? Most contempo URR of seventy% to.. Read more..
Modifier G5
What Is A G5 Modifier? Most recent URR of 75% or.. Read more..
Modifier G6
What Is A G6 Modifier? ESRD patient for whom less than seven dialysis sessions have been.. Read more than..
Modifier G7
What Is A G7 Modifier? Pregnancy resulted from rape or incest or pregnancy certified by dr. as life threatening
Modifier GA
What Is GA Modifier? Waiver of liability statement on file.
Use modifier GA to indicate that the physician's part has a signed advance find retained in the patient's medical record. The notice is for services that may be denied by Medicare.
Usage of Modifier GA: Modifier GA must be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny a service as not reasonable and necessary.
For more information about GA Modifier, you tin can refer to this article.
Modifier GC
What Is A GC Modifier? This service has been performed in part past a resident under the direction of a teaching medico.
Modifier GD
Clarification of Modifier GD: Units of service exceeds medically unlikely edit value and represents reasonable and necessary services.
Modifier GE
What Is A GE Modifier? This service has been performed past a resident without the presence of a teaching physician nether the main care exception.
Modifier GF
What Is A GF Modifier? Md services provided by a nonphysician in a critical access hospital; nonphysician: NP, Certified Registered Nurse Anesthetist (CRNA), Certified Registered Nurse (CRN), CNS or PA.
Modifier GG
What Is A GG Modifier? Diagnostic Mammography.
Utilize modifier GG to indicate functioning and payment of a screening mammography and diagnostic mammography on same patient, on the same twenty-four hours.
Modifier GH
What Is A GH Modifier? Diagnostic mammogram converted from screening mammogram on aforementioned mean solar day.
Modifier GJ
What Is A GJ Modifier? Opted Out physician or practitioner.
Use modifier GJ to indicate services performed in an emergency or urgent service.
Usage of Modifier GJ: In an emergency or urgent care situation, a provider may care for a Medicare beneficiary with whom he or she does not have a private contract and beak Medicare for such treatment.
The provider may not charge the beneficiary more than.. Read more..
Modifier GM
What Is A GM Modifier? Multiple patients on ane ambulance trip.
Modifier GN
What Is A GN Modifier? Services delivered nether an outpatient speech linguistic communication pathology plan of care.
Modifier Get
What Is A Get Modifier? Services delivered under an outpatient occupational therapy program of care.
Modifier GP
What Is A GP Modifier? Services delivered nether an outpatient concrete therapy plan of intendance.
Modifier GQ
What Is A GQ Modifier? Telehealth services via asynchronous telecommunications organisation.
Modifier GR
What Is A GR Modifier? This service was performed in whole or in part by a resident in a department of Veterans Affairs Medical Center or clinic supervised in accordance with VA policy.
Modifier GS
What Is A GS Modifier? Dosage of EPO or Darbepoietin Alfa has been reduced and maintained in response to hematocrit or hemoglobin level.
Modifier GT
What Is A GT Modifier? : Telehealth services via interactive audio and video telecommunication systems.
Modifier GU
What Is A GU Modifier? Waiver of liability statement issued equally required by a payer policy, routine find.
Modifier GW
What Is A GW Modifier? Service non related to the hospice patient's concluding condition.
Modifier GV
What Is A GV Modifier? Attending dr. not employed or paid under understanding by the patient's hospice provider.
Modifier GY
What Is A GY Modifier? Apply to signal when an particular or service statutorily excluded or does non meet the definition of any Medicare benefit.
Modifier GZ
What Is GZ Modifier? Employ to indicate when an item or service expected to be denied as not reasonable and necessary.
Apply modifier GZ when no Advanced Beneficiary Find (ABN) signed by the beneficiary.
Usage of Modifier GZ: The GZ modifier must be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny an particular or service as non reasonable and necessary.
For more data almost GZ Modifier, please refer to this article..
Modifier HM
What Is A HM Modifier? Less than Available's caste level.
Modifier HN
What Is A HN Modifier? : Bachelor's caste level.
Modifier HO
What Is A HO Modifier? Main's degree level,
Modifier HP
What Is A HP Modifier? : Doctoral level.
Modifier HQ
What Is A HQ Modifier? Group setting (for behavioral health utilise).
Modifier HT
What Is A HT Modifier? Multidisciplinary team (for behavioral health apply).
Modifier H9
What Is A H9 Modifier? : Court-ordered.
Modifier HU
What Is A HU Modifier? Funded by child welfare bureau.
Modifier HV
What Is A HV Modifier? Funded state addictions agency.
Modifier HW
What Is A HW Modifier? Funded by land mental health agency.
Modifier HX
What Is A HX Modifier? Funded by county/local agency
Modifier HY
What Is A HY Modifier? Funded by juvenile justice agency.
Modifier HZ
What Is A HZ Modifier? Funded by criminal justice bureau.
Modifier J1
What Is A J1 Modifier? Competitive Acquisition Program, no-pay submission for a prescription number.
Modifier J2
What Is A J2 Modifier? Competitive Acquisition Program, restocking of emergency drugs after emergency assistants.
Modifier J3
What Is A J3 Modifier? Competitive Conquering Programme, (CAP) drug not bachelor through CAP equally written, reimburse nether ASP Methodology.
Modifier JA
What Is A JA Modifier? Administered intravenously.
Modifier JB
What Is A JB Modifier? Administered subcutaneoulsly.
Modifier JC
What Is A JC Modifier? Skin substitute used as a graft.
Modifier JD
What Is A JD Modifier? Pare substitute NOT used as a graft.
Modifier JW
What Is A JW Modifier? Drug or biological amount discarded/non administered to any patient.
Modifier KB
What Is A KB Modifier? Beneficiary requested upgrade for ABN, more than 4 modifiers identified on claim
Modifier KC
What Is A KC Modifier? Replacement of special power wheelchair interface.
Modifier KD
What Is A KD Modifier? Drug or Biological infused through implanted DME.
Modifier KE
What Is A KE Modifier? Bid nether circular one of the DMEPOS competitive behest programme for utilize with not-competitive bid base equipment.
Modifier KF
What Is A KF Modifier? Item designated by FDA as Grade III device.
Usage of Modifier KF: Modifier KF is a pricing modifier. The HCPCS codes for DME designated every bit class 3 devices by the FDA are identified on the DMEPOS fee schedule by presence of the KF modifier.
The KF Modifier is applicable only for.. Read more..
Modifier KL
What Is A KL Modifier? : DMEPOS Particular Delivered via Mail.
Usage of Modifier KL: Contract suppliers must use the KL Modifier on all claims for diabetic supply codes that are furnished via mail order.
Non contract suppliers that furnish post order diabetic supplies to beneficiaries who do non alive in.. Read more..
Modifier KM
What Is A KM Modifier? Replacement of facial prosthesis – including new impression/moulage.
Usage of Modifier KM: KM Modifier and KN Modifier are to be used on claims for replacement of items identified by codes L8040 thru L8047 that are furnished on or after January ane, 2005.
Payment for codes L8040 thru L8047 is based on the.. Read more than..
Modifier KN
What Is A KN Modifier? Replacement of facial prosthesis – Using previous master model.
Usage of Modifier KM: KM Modifier and KN Modifier are to be used on claims for replacement of items identified by codes L8040 thru L8047 that are furnished on or later on January 1, 2005.
Payment for codes L8040 thru L8047 is based on the.. Read more..
Modifier KR
What Is A KR Modifier? Rental item, durable medical equipment – billing for partial month.
Modifier KX
What Is A KX Modifier? Specific required documentation on file (used for DMERC providers).
Modifier KZ
What Is A KZ Modifier? New Coverage not implemented past managed care.
Modifier LC
What Is A LC Modifier? Left circumflex coronary artery.
Modifier LD
What Is A LD Modifier? Left anterior descending coronary artery.
Modifier LM
What Is A LM Modifier? Left main coronary artery.
Modifier LR
What Is A LR Modifier? Laboratory Round Trip.
Modifier LT
What Is A LT Modifier? Left Side – Used to place procedures performed on the left side of the trunk.
Modifier M2
What Is A M2 Modifier? Medicare Secondary Payer.
Modifier NB
What Is A NB Modifier? Nebulizer organisation, any type, FDA-Cleared fo ruse with specific drug.
Modifier NU
What Is A NU Modifier? New equipment (DME).
Modifier P1
What Is A P1 Modifier? A normal salubrious patient.
Modifier P2
What Is A P2 Modifier? A patient with mild systemic disease.
Modifier P3
What Is A P3 Modifier? A patient with astringent systemic disease.
Modifier P4
What Is A P4 Modifier? A patient with severe systemic disease that is a constant threat to life.
Modifier P5
What Is A P5 Modifier? A moribund patient who is not expected to survive without the performance.
Modifier P6
What Is A P6 Modifier? A alleged encephalon-expressionless patient whose organs are being removed for donor purposes.
Modifier PA
What Is A PA Modifier? Surgery Incorrect Trunk Function.
Modifier Lead
What Is A PB Modifier? Surgery Incorrect Patient.
Modifier PC
Modifier PD
What Is A PD Modifier? : Diagnostic or related not-diagnostic detail or service provided in a wholly owned or wholly operated entity to a patient who is admitted as an inpatient inside 3 days, or i day.
Modifier PI
What Is A PI Modifier? PET Tumor init tx strategy.
Modifier PS
What Is A PS Modifier? PET Tumor subsq tx strategy.
Modifier PT
What Is A PT Modifier? Colorectal cancer screening test; converted to diagnostic test or other procedure.
Modifier PO
What Is A PO Modifier? Services, procedures and/or surgeries provided at off-campus provider-based outpatient departments.
Modifier Q0
What Is A Q0 Modifier? Investigational clinical service provided in a clinical research written report that is in an canonical clinical research study.
Modifier Q1
What Is A Q1 Modifier? Routine clinical service provided in a clinical inquiry study that is in an approved clinical research study.
Modifier Q3
What Is A Q3 Modifier? Liver Kidney Donor Surgery and Related Services.
Modifier Q4
What Is A Q4 Modifier? Service for ordering/referring physician qualifies as a service exemption.
Modifier Q5
What Is A Q5 Modifier? Service furnished past a substitute physician under a reciprocal billing arrangement.
Modifier Q6
Des What Is A Q6 Modifier? Service furnished by a locum tenens physician.
Modifier Q7
What Is A Q7 Modifier? One CLASS A finding.
Modifier Q8
What Is A Q8 Modifier? Two CLASS B findings.
Modifier Q9
What Is A Q9 Modifier? One Course B and ii CLASS C findings.
Modifier QA
What Is A QA Modifier? FDA Investigational device exemption (IDE) – The IDE projection number must exist included on the claim when modifier QA is billed.
Modifier QB
What Is A QB Modifier? Medico service in a rural HPSA.
Modifier QC
What Is A QC Modifier? Unmarried aqueduct monitoring.
Modifier QD
What Is A QD Modifier? Recording and storage in solid state memory by a digital recorder.
QJ Services/items provided to a prisoner or patient in land or local custody, still the state or local government, equally applicable, meets the requirements in 42 CFR 411.4 (B).
Modifier QK
What Is A QK Modifier? : Medical direction of two, 3 or 4 concurrent anesthesia procedures involving qualified individuals.
Modifier QL
What Is A QL Modifier? Patient pronounced dead after ambulance called
Modifier QM
What Is A QM Modifier? Ambulance service provided under arrangement by a provider of services
Modifier QN
What Is A QN Modifier? Ambulance service furnished directly by a provider of services
QP Panel test.
Documentation is on file showing that the laboratory examination(s) was ordered individually or ordered as a CPT recognized panel other than automated profile codes.
Modifier QQ
What Is A QQ Modifier? Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional.
Usage of Modifier QQ: Used when the furnishing professional person is aware of the consequence of the ordering professional'due south consultation with a CDSM for that patient.
Modifier QQ is reported on the aforementioned claim line equally the CPT code for an avant-garde diagnostic imaging.. Read more..
Modifier QS
What Is A QS Modifier? Monitored anesthesia care.
Modifier QT
What Is A QT Modifier? Recording and storage on tape by an analog record recorder.
Modifier QU
What Is A QU Modifier? Physician service in an urban HPSA.
Modifier QV
What Is A QV Modifier? Particular or service provided as routine care in a medical qualifying clinical trial.
Modifier QW
What Is A QW Modifier? CLIA Waived Test. Effective October 1, 1996, all new waived tests are being assigned a CPT code (in lieu of a temporary five-digit G- or Q-code).
Modifier QX
What Is A QX Modifier? CRNA service with medical management by physician.
Modifier QY
What Is A QY Modifier? Medical management of ane certified registered nurse anesthetist (CRNA) by an anesthesiologist.
Modifier QZ
What Is A QZ Modifier? CRNA service without medical direction by a physician.
Modifier RA
What Is A RA Modifier? : Replacement of a DME item, Orthotic or Prosthetic Item
Modifier RB
What Is A RB Modifier? Replacement of a Part of DME, Orthotic or Prosthetic Item furnished as Function of a Repair
Modifier RC
What Is A RC Modifier? Correct coronary artery.
Modifier RD
Modifier RD: Drug provided to beneficiary.
Modifier RE
What Is A RE Modifier? Furnished in full compliance with FDA-Mandated Risk Evaluation and Mitigation Strategy (REMS).
Modifier RI
What Is A RI Modifier? Ramus intermedius (Constructive for the year 2013).
Modifier RP
What Is A RP Modifier? Replacement and repair.
Modifier RT
What Is A RT Modifier? Right Side. The RT modifier is used to identify procedures performed on the correct side of the body.
Modifier RR
What Is A RR Modifier? Rental (use the RR modifier when DME is a rental)
Modifiers SB NP
What Is A SB NP Modifier? : (for use past midwives only).
Modifier SC
What Is A SC Modifier? Medically necessary service or supply (w.e.f Jan ane, 2012).
Modifier SF
What Is A SF Modifier? Second opinion ordered by a Professional Review Arrangement (PRO) per department 9401, P.Fifty. 99-272 (100 % reimbursement – no Medicare deductible or coinsurance).
Modifier SG
What Is A SG Modifier? SG Ambulatory Surgical Center (ASC) modifier.
Modifier SH
What Is A SH Modifier? 2nd concurrently administered infusion therapy
SJ 3rd or more than concurrently administered infusion therapy.
Modifier SK
What Is A SK Modifier? Member of high risk population (Apply merely with codes for immunization).
Modifier SS
What Is A SS Modifier? Home infusion services provided in the infusion suite of the IV therapy provider.
Modifier SW
What Is A SW Modifier? Services provided by a certified diabetes educator.
Modifier TA
What Is A TA Modifier? Left foot, great toe.
Modifier T1
What Is A T1 Modifier? Left human foot, second digit.
Modifier T2
What Is A T2 Modifier? Left foot, tertiary digit
Modifier T3
What Is A T3 Modifier? Left foot, fourth digit.
Modifier T4
What Is A T4 Modifier? Left foot, fifth digit.
Modifier T5
What Is A T5 Modifier? Correct pes, great toe.
Modifier T6
What Is A T6 Modifier? Correct foot, 2d digit.
Modifier T7
What Is A T7 Modifier? Right human foot, tertiary digit.
Modifier T8
What Is A T8 Modifier? Right human foot, quaternary digit.
Modifier T9
What Is A T9 Modifier? Right human foot, fifth digit.
Modifier TC
What Is A TC Modifier? Technical component only. Use modifier TC to indicate the technical function of a diagnostic procedure performed.
Modifier TD
What Is A TD Modifier? Registered Nurse (RN) (for behavioral health use).
Modifier TE
What Is A TE Modifier? Licensed Practical Nurse (LPN) (for behavioral wellness use).
Modifier TJ
What Is A TJ Modifier? Child/Adolescent Program GP: To exist used for enhancement payment for foster care children screening exams.
Modifier TK
What Is A TK Modifier? Extra member or passenger, nonambulance transportation.
Modifier TR
What Is A TR Modifier? School-based individualized education program services provided outside the public school commune responsible for the educatee.
Modifier TS
What Is A TS Modifier? Follow-upwards service.
Modifier UE
What Is A UE Modifier? Used durable medical equipment.
Modifier Un
What Is A UN Modifier? Portable X-ray Modifiers; ii patients.
Modifier Up
What Is A UP Modifier? Portable X-ray Modifiers; three patients.
Modifier UQ
What Is A UQ Modifier? Portable X-ray Modifiers; four patients.
Modifier UR
What Is A UR Modifier? Portable 10-ray Modifiers; five patients.
Modifier US
What Is A US Modifier?: Portable X-ray Modifiers; half dozen patients.
Modifier V1
What Is A V1 Modifier? Level of MMI for Treating Doctor.
Modifier V1 would be added to the "Work related or medical inability exam by the treating doc…".
CPT code 99455 when the office visit level of service is equal to a "minimal" level.
Modifier V2
What Is A V2 Modifier? Level of MMI for Treating Doctor.
Modifier V2 would be added to the "Work related or medical disability examination by the treating physician…"
CPT lawmaking 99455 when the office visit level of service is equal to "self limited or pocket-sized" level.
Modifier V3
What Is A V3 Modifier? Level of MMI for Treating Doctor.
Modifier V3 would be added to the "Work related or medical disability examination by the treating physician…"
CPT code 99455 when the office visit level of service is equal to "low to moderate" level.
Modifier V4
What Is A V4 Modifier? Level of MMI for Treating Doctor.
Modifier V4 would be added to the "Work related or medical disability examination past the treating physician…".
CPT code 99455 when the office visit level of service is equal to "moderate to high severity" level and of at to the lowest degree 25 minutes duration.
Modifier V5
What Is A V5 Modifier? Level of MMI for Treating Doctor.
Modifier V5 would exist added to the "Piece of work related or medical inability examination by the treating.. Read more..
Modifier V6
What Is A half dozen Modifier? Arteriovenous Graft (or other vascular access not including a vascular.. Read more than..
Modifier V7
What Is A V7 Modifier? Afteriovenous Fistula (or other vascular admission not including a vascular.. Read more..
Modifier V8
What Is A V8 Modifier? Dialysis related infection nowadays during the billing month – Part A just modifier.
Usage of Modifier V8: Reportable dialysis admission-related infection is express to peritonitis for peritoneal dialysis patients or bacteremia for hemodialysis patients.
Facilities must report any peritonitis related to a peritoneal dialysis catheter and.. Read more than..
Modifier V9
What Is A V9 Modifier? No dialysis related infection present during the billing calendar month – Part A only modifier.
Usage of Modifier V9: No dialysis-access related infection, every bit defined for modifier V8, is present during the billing month.
Dialysis access-related infection, defined as peritonitis for peritoneal dialysis patients or bacteremia for.. Read more..
Modifier VR
What Is A VR Modifier? Review study. Modifier VR shall be added to the "Piece of work related or medical disability examination past the treating physician…".
CPT code 99455 to bespeak that the service was the treating doctor'southward review of report(southward) only.
Modifier XE
What Is A XE Modifier? Separate encounter.
Modifier XE can be used for a service that is distinct considering it occurred during.. Read more..
Modifier XS
What Is A XS Modifier? Split up structure.
Modifier XS can be used for a service that is singled-out because it was performed.. Read more..
Modifier XP
What Is A XP Modifier? Split up Practitioner.
Modifier XP can be used for a service that is singled-out considering it was performed by.. Read more than..
Modifier XU
What Is A XU Modifier? Unusual non-overlapping service.
Modifier XU can be used for a service that is.. Read more..
Modifier ZA
What Is A ZA Modifier? (Anesthesia modifier particularly used for Medi-cal insurance of California) denotes prone position or surgical field avoidance.
Apply modifier ZA only for procedures that take a base value of three (iii) units. These techniques are included in the anesthesia base value of surgical procedures with a base of operations value of more 3.
Modifier ZE
What Is A ZE Modifier? (Anesthesia modifier particularly used for Medical insurance of California).
Modifier ZE tin only exist billed with the advisable five-digit CPT-iv anesthesia code to place a normal, uncomplicated anesthesia provided past a Certified Registered Nurse Anesthetist (CRNA).
Annotation: Delight check the respective insurance guidelines for advisable usage of Modifiers to avoid denials.
Source: https://www.codingahead.com/list-of-modifiers-html/
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