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Miranda Modifiers

TermDefinition
-22 Increased Procedural Service (triggers an audit) Indicates services significantly greater than usual
-23 Unusual Anesthesia Use of anesthesia where no anesthesia or local would be the norm, Only used with anesthesia codes Highly agitated senile patient
-24 Unrelated E/M Services by Same Physician or other qualified health care professional during a postoperative global period
-25 Significant, Separately Identifiable E/M service, by the same physician or other qualified health care professional and same day of procedure or other service
-26 Professional Component
-32 Mandated service Mandated by payer, workers’ comp or official body.
-33 Preventive Services
-47 Anesthesia by Surgeon Physician administers regional or general anesthesia and Only used with Surgery codes
-50 Bilateral Procedure
-51 Multiple Procedure-Three Types Same procedure, different sites Multiple operation (s), Same operative session Procedure Performed Multiple Times
-52 Reduced Services
-53 Discontinued Procedure Surgical/diagnostic procedures, Started then stopped due to patient’s condition
-54 Surgical Care Only Physician provides only procedure (intraoperative)
-55 Postoperative Management Only Physician provides care only after hospital discharge
-56 Preoperative Management only Physician provided only preoperative care
-57 Decision for surgery used with E/M, 99201-99499 Medicine, 92012-92014 ophthalmologic services
-58 Staged/Related Procedure/Service by Same Physician or Other Qualified Health Care Professional During Postoperative Period Subsequent procedure planned or related to the first surgery
-59 Distinct Procedural service Different session or encounter, procedure, and/or site Separate incision, excision, lesion, injury
-62 Two surgeons
-63 Procedure performed on infants less than 4kg
-66 Surgical team
-77 Repeat Procedure/Service by Another Physician or Other Qualified Health Care Professional
-78 Unplanned Return to Operating/Procedure Room Same Physician Following Initial Procedure for a Related Procedure During Postoperative Period
-79 79 Unrelated Procedure or Service by Same Physician or Other Qualified Health Care Professional During Postoperative Period
-80/-81 Assistant and Minimum Assistant Surgeons
-82 Assistant Surgeon
-90 Reference (outside) Laboratory
-91 Repeat Clinical Diagnostic Laboratory Test
-92 Alternative Laboratory Platform Testing
-99 Multiple Modifiers
Created by: mirandaag.
 

 



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