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HCPCS Modifiers

HCPCS/National modifiers

LT left side of the body
RT right side of the body
AI principle physician of record
BL special acquisition of blood and blood products
CA procedure only payable in inpatient setting when performed emergently on an outpatient who expires prior to admission
CR catastrophe/disaster related
E1 upper left eyelid
E2 lower left eyelid
E3 upper right eyelid
E4 lower right eyelid
FA left hand thumb
F1 left hand second digit
F2 left hand third digit
F3 left hand fourth digit
F4 left hand fifth digit
F5 right hand thumb
F6 right hand second digit
F7 right hand third digit
F8 right hand fourth digit
F9 right hand fifth digit
FB item provided without cost or full credit received for replaced device
FC partial credit received for replaced device
GA waiver of liability statement issued as required by payer policy, individual case
GG performance & payment of a screening mammogram and diagnostic mammogram on same patient on same day
GH screening mammogram converted to diagnostic mammogram on same day
LC left circumflex coronary artery
LD left anterior descending coronary artery
LM left main coronary artery
Q0 investigational clinical service provided in an approved clinical research study
Q1 routine clinical service provided in an approved research study
QM ambulance service provided under arrangement by a provider of services
QN ambulance service furnished directly by a provider of service
RC right coronary artery
RI ramus intermedius coronary artery
TA left foot great toe
T1 left foot second digit
T2 left foot third digit
T3 left foot fourth digit
T4 left foot fifth digit
T5 right foot great toe
T6 right foot second digit
T7 right foot third digit
T8 right foot fourth digit
T9 right foot fifth digit
Created by: Tonya