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Medical Billing
Modifiers
| Question | Answer |
|---|---|
| Modifier -22 | Unusual Services: When the service(s) provide is substantially greater than that usually required for the listed procedure, it may be identified by adding modifier. |
| Modifier -23 | Unusual Anesthesia: Occasionally a procedure that usually requires either no anesthesia or local anesthesia must be done under general anesthesia because of unusual circumstances. |
| Modifier -24 | Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period: The physician may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s). |
| Modifier -25 | Significant, Separately Identifiable Evaluation and Management Service by the same Physician on the Same Day of a Procedure or Other Service. |
| Modifier -26 | Professional Component: Certain procedures are a combination of a physician component and technical component. |
| Modifier -32 | Mandated Services: Services related to mandated consultation and/or related services may be identified by adding the modifier. |
| Modifier -33 | Preventive Services: When the primary purpose of the service is the delivery of an evidence-based service in accordance with a U.S. Preventive Services Task Force A or B rating in effect and other preventive services identified in preventive ser.mandates. |
| Modifier -47 | Anesthesia by Surgeon: Regional or general anesthesia provided by the surgeon may be reported by adding the modifier. |
| Modifier -50 | Bilateral Procedure: Unless otherwise identified in the listings, bilateral procedures that are performed at the same operative session should be identified by the appropriate 5-digit code # describing the 1st procedure. 2nd proced. is by adding modifier. |
| Modifier -51 | Multiple Procedures: When multiple procedures other that E/M services are performed at the same session by the same provider, the primary procedure or service may be reported as listed. |
| Modifier -52 | Reduced Services: Under certain circumstances, a services or procedure is partially reduced or eliminated at the physician's descretion. |
| Modifier -53 | Discontinued Procedure: Under certain circumstances, the physician may elect to terminate a surgical or diagnostic procedure. |
| Modifier -54 | Surgical Care Only: When one physician performs surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding the modifier. |
| Modifier -55 | Postoperative Management Only: When on physician performs the postoperative management and another physician performs the surgical procedure , the postoperative component may be identified by adding the modifier. |
| Modifier -56 | Preoperative Management Only: When one physician performs the preoperative care and evaluation and another physician performs the surgical procedure, the preoperative component may be identified by adding the modifier. |
| Modifier -57 | Decision for Surgery: An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding the modifier. |
| Modifier -58 | Staged or Related Procedure or Service by the Same Physician During the Postoperative Period. |
| Modifier -59 | Distinct Procedural Service. |
Created by:
rochelle1977
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