Modifiers
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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| 22 | Increased Procedural Services
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| 23 | Unusual Anesthesia
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| 24 | Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period.
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| 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.
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| 26 | Professional Component
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| 27* | Multiple Outpatient Hospital E/M encounters on the same date.
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| 32 | Mandated Services
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| 33 | Preventive Services
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| 47 | Anesthesia by Surgeon
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| 50* | Bilateral Procedure
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| 51 | Multiple Procedures
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| 52* | Reduced Services
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| 53 | Discontinued Procedure
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| 54 | Surgical Care Only
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| 55 | Postoperative Management Only
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| 56 | Preoperative Management Only
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| 57 | Decision for Surgery
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| 58* | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period.
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| 59* | Distinct Procedural Service
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| 62 | Two Surgeons
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| 63 | Procedure performed on infant less than 4 kgs
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| 66 | Surgical Team
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| 73* | Discontinued outpatient procedure prior to anesthesia administration.
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| 74* | Discontinued outpatient procedure after anesthesia administration.
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| 76* | Repeat procedure or service by same physician or other qualified health care professional.
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| 77* | Repeat procedure or service by another physician or other qualified health care professional.
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| 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.
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| 79* | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period.
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| 80 | Assistant Surgeon
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| 81 | Minimum Assistant Surgeon
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| 82 | Assistant Surgeon (when qualified resident surgeon not available)
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| 90 | Reference (outside) Laboratory
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| 91 | Repeat clinical diagnostic laboratory test.
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| 92 | Alternative laboratory platform testing.
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| 99 | Multiple Modifiers
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| P1 | A normal healthy patient
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| P2 | A patient with mild systemic disease
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| P3 | A patient with severe systemic disease.
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| P4 | A patient with severe systemic disease that is a constant threat to life.
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| P5 | A moribund patient who is not expected to survive without the operation.
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| P6 | A declared brain-dead patient whose organs are being removed for donor purposes.
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| LT** | Left Side
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| RT** | Right Side
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| AI** | Principal physician of record
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| BL** | Special acquisition of blood and blood products.
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| CA** | Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission.
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| CR** | Catastrophe/disaster related
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| E1** | Upper left, eyelid
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| E2** | Lower left, eyelid
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| E3** | Upper right, eyelid
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| E4** | Lower right, eyelid
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| FA** | Left hand, thumb
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| F1** | Left hand, second digit
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| F2** | Left hand, third digit
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| F3** | Left hand, fourth digit
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| F4** | Left hand, fifth digit
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| F5** | Right hand, thumb
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| F6** | Right hand, second digit
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| F7** | Right hand, third digit
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| F8** | Right hand, fourth digit
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| F9** | Right hand, fifth digit
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| FB** | Item provided without cost to provider, supplier or practitioner, or full credit received for replacement device.
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| FC** | Partial credit received for replacement device.
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| GA** | Waiver of liability statement on file
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| GG** | Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day.
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| GH** | Diagnostic mammogram converted from screening mammogram on same day.
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| LC** | Left circumflex, coronary artery.
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| LD** | Left anterior descending coronary artery.
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| RC** | Right coronary artery
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| Q0** | Investigational clinical service provided in a clinical research study that is in an approved clinical research study.
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| Q1** | Routine clinical service provided in a clinical research study that is in an approved clinical research study.
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| QM** | Ambulance service provided under arrangement by a provider of services.
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| QN** | Ambulance service furnished directly by a provider of services.
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| TA** | Left foot, great toe
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| T1** | Left foot, second digit
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| T2** | Left foot, third digit
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| T3** | Left foot, fourth digit
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| T4** | Left foot, fifth digit
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| T5** | Right foot, great toe
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| T6** | Right foot, second digit
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| T7** | Right foot, third digit
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| T8** | Right foot, fourth digit
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| T9** | Right foot, fifth digit
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| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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| 1P | Performance Measure Exclusion Modifier due to Medical Reasons
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| 2P | Performance Measure Exclusion Modifier due to Patient Reasons
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| 3P | Performance Measure Exclusion Modifier due to System Reasons
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| 8P | Performance measure reporting modifier-action not
performed, reason not otherwise specified
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Created by:
Laura Duncan
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