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Miranda Modifiers
| Term | Definition |
|---|---|
| -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 |