When to use a Modifier
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Modifier 22 | “when the service(s) provided is greater than that usually required for the listed procedure,”
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| Modifier 23 | Unusual Anesthesia
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| Modifier 24 | Unrelated evaluation and management service by the same physician during postoperative period.
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| Modifier 25 | Significant, separately identifiable E&M service by the same physician on the same day of a procedure or other service
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| Modifier 26 | it indicates that procedure being reported as professional component only.
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| Modifier 32 | Mandated Services.-You should append modifier 32 (Mandated services) to any service that the physician provides at the specific request of the patient’s insurer.
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| Modifier 47 | You should apply modifier 47 (Anesthesia by surgeon) if the surgeon administers his or her own anesthesia during a surgical procedure.
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| Modifier 50 | Bilateral Procedure
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| Modifier 51 | Muliple Procedures
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| Modifier 52 | Reduced Services-Modifier 52 Reduced Services; is used when a service / procedure was not completed in its entirety.
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| Modifier 53 | Discontinued Procedure
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| Modifier 54 | Surgical Care Only-When one physician performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services
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| Modifier 55 | Postoperative Management Only-When one physician performed the postoperative management and another physician performed the surgical procedure
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| Modifier 56 | Preoperative Management Only-When one physician performed the preoperative care and evaluation and another physician performed the surgical procedure
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| Modifier 57 | Decision for Surgery-the initial decision to perform a surgical procedure, either the day before or the day of an urgent or emergent surgery
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| Modifier 58 | staged or related procedure or service by the same physician during the postoperative period
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| Modifier 59 | Distinct procedural service-is used to indicate that a procedure was distinct or independent from other services performed on the same date unless the codes are bundeled.
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| Modifier 62 | Two Surgeons-Two surgeons (each in a different specialty) are required to perform a specific procedure
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| Modifier 63 | Procedure performed on infants less than 4kgs
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| Modifier 66 | Surgical Team-If a team of surgeons (more than two surgeons of different specialties) is required to perform a specific procedure
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| Modifier 76 | Repeat procedure or service by same physician
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| Modifier 77 | Repeat procedure or service by another physician
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| Modifier 78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period
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| Modifier 79 | Unrealted procedure or service by the same physician during the postoperative period
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| Modifier 80 | Assistant Surgeon
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| Modifier 81 | Minimum Assistant Surgon
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| Modifier 82 | Assistant Surgeon when qualified resident surgeon not available
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| Modifier 90 | Reference Outside Laboratory- if you are an independent lab billing for a test that you did not perform in-house
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| Modifier 91 | Repeat Clinical Diagnostic Labratory Test-should be appended to laboratory procedure(s) or service(s) to indicate a repeat test or procedure on the same day.
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| Modifier 92 | Alternative Labratory Platform Testing-this would be attached to a certain laboratory procedure you had done. --Not a standard test.
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| Modifier 99 | Muliple Modifiers
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To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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Created by:
lorireid1980
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