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CPT Modifiers

Modifiers

TermDefinition
22 Increased Procedural Services
23 Unusual Anesthesia
24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period.
25* Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service.
26 Professional Component
27* Multiple Outpatient Hospital E/M encounters on the same date.
32 Mandated Services
33 Preventive Services
47 Anesthesia by Surgeon
50* Bilateral Procedure
51 Multiple Procedures
52* Reduced Services
53 Discontinued Procedure
54 Surgical Care Only
55 Postoperative Management Only
56 Preoperative Management Only
57 Decision for Surgery
58* Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period.
59* Distinct Procedural Service
62 Two Surgeons
63 Procedure performed on infant less than 4 kgs
66 Surgical Team
73* Discontinued outpatient procedure prior to anesthesia administration.
74* Discontinued outpatient procedure after anesthesia administration.
76* Repeat procedure or service by same physician or other qualified health care professional.
77* Repeat procedure or service by another physician or other qualified health care professional.
78* Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period.
79* Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period.
80 Assistant Surgeon
81 Minimum Assistant Surgeon
82 Assistant Surgeon (when qualified resident surgeon not available)
90 Reference (outside) Laboratory
91 Repeat clinical diagnostic laboratory test.
92 Alternative laboratory platform testing.
99 Multiple Modifiers
P1 A normal healthy patient
P2 A patient with mild systemic disease
P3 A patient with severe systemic disease.
P4 A patient with severe systemic disease that is a constant threat to life.
P5 A moribund patient who is not expected to survive without the operation.
P6 A declared brain-dead patient whose organs are being removed for donor purposes.
LT** Left Side
RT** Right Side
AI** Principal physician of record
BL** Special acquisition of blood and blood products.
CA** Procedure payable only in the 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 to provider, supplier or practitioner, or full credit received for replacement device.
FC** Partial credit received for replacement device.
GA** Waiver of liability statement on file
GG** Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day.
GH** Diagnostic mammogram converted from screening mammogram on same day.
LC** Left circumflex, coronary artery.
LD** Left anterior descending coronary artery.
RC** Right coronary artery
Q0** Investigational clinical service provided in a clinical research study that is in an approved clinical research study.
Q1** Routine clinical service provided in a clinical research study that is in an approved clinical research study.
QM** Ambulance service provided under arrangement by a provider of services.
QN** Ambulance service furnished directly by a provider of services.
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
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
1P Performance Measure Exclusion Modifier due to Medical Reasons
2P Performance Measure Exclusion Modifier due to Patient Reasons
3P Performance Measure Exclusion Modifier due to System Reasons
8P Performance measure reporting modifier-action not performed, reason not otherwise specified
Created by: Laura Duncan
 

 



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