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Chapter 6 HCPCS, Alpha/Numeric Modifiers, Abbreviations

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Term
Definition
A Codes   Transportation codes (A0021-A0999), medical and surgical supplies (A4206-A8004), and administrative, miscellaneous and investigational services, equipment, and supplies (A9150-A9999)  
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B Codes   Enteral and parenteral therapy (B4000-B9999)  
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C Codes   Temporary codes for use with Outpatient Prospective Payment System (OPPS) (pass through) (C1300-C9899)  
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E Codes   Durable Medical Equipment (E0100-E8002)  
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G Codes   Procedures /professional services (temporary) (G0008-G9156)  
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H Codes   Temporary national codes for governmental entities other than Medicare (H0001-H2037)  
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J Codes   Drugs administered other than oral method (J0120-J8499) and Chemotherapy drugs (J8501-J9999)  
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K Codes   Assigned to DME MAC (K0000-K0899)  
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L Codes   Orthotic procedures and devices (L0000-L4999) and prosthetic procedures (L5000-L9900)  
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M Codes   Medical Services (M0000-M0301)  
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P Codes   Pathology and Laboratory Services (P0000-P9999)  
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Q Codes   Procedures, Services, and supplies on a temporary basis (Q0035-Q9968)  
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R Codes   Diagnostic radiology services (R0000-R9999)  
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S Codes   Temporarily national codes (non Medicare) (S0000-S9999)  
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T Codes   National codes established for state Medicaid agencies (T1000-T9999)  
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V Codes   Vision Services (V0000-V2999) and hearing, which also includes speech-language pathology service (V5000-V5999)  
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IA   Intra-arterial Administration - Administration of the drug is given within an artery.  
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IV   Intravenous administration - Administration of the drug is given into the vein.  
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IM   Intramuscular administration - Administration of the drug via an injection into a muscle.  
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IT   Intrathecal - Administration of the drug is given into the subdural space of the spinal cord.  
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SC   Subcutaneous administration - Administration of the drug via an injection just under the skin.  
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INH   Administration by inhaled solution - Administration of the drug by breathing it.  
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VAR   Various routes of administration - Administration of the drug by various routes commonly administered into joints, cavities, tissues, or topical applications  
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OTH   Other routes of administration - other administration methods like suppositories or catheter injections.  
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ORAL   Administered orally - Administration of the drug via taking it by mouth.  
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Medicare Carriers Manual (MCM) References   Includes the Coverage Issue Manual (CIM) references, the Medicare Carriers Manual references contain CMS regulations and rulings concerning coverage procedures, services, and supplies.  
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Medicare Statutes   The appendix covers statutory coverage issues (eg, 1862 [42 U.S.C. 1395y] (a)(1)(A)-(21), Exclusions from coverage and Medicare as Secondary Payer).  
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E1   Upper left, eyelid  
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F5   Right hand, thumb  
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ET   Emergency services  
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GM   Multiple patients on one ambulance trip  
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HF   Substance abuse program  
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RC   Right coronary artery  
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Q6   Service furnished by a locum tenens physician  
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D   Diagnostic or therapeutic site other then "P" or "H" when these codes are used as origin codes  
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E   Residential, domiciliary, custodial facility (other than an 1819 facility)  
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G   Hospital-based ESRD facility (hospital or hospital related)  
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H   Hospital  
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I   Site of transfer (eg. airport or helicopter pad between modes of ambulance transport)  
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J   Freestanding ESRD facility  
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N   Skilled nursing facility (SNF) (1819 facility)  
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P   Physician's office  
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R   Residence  
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S   Scene of accident or acute event  
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X   (Destination code only) Intermediate stop at physician's office on the way to the hospital.  
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HH   Ambulance trip from discharge/transfer from one hospital to another hospital  
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RH   Ambulance trip from the patient's residence to a hospital  
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SH   Ambulance trip from scene of accident to a hospital  
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RP   Ambulance trip from the patient's residence to a physician's office  
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Transportation Services including Ambulance For Ground   Basic life support (BLS); Advanced life support, Level 1 (ALS1); Advanced life support, Level 2 (ALS2); Specialty care transport (SCT); Paramedic ALS intercept (P1)  
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Transportation Services including Ambulance For AIR   Fixed wing air ambulance (FW); Rotary wing air ambulance (RW)  
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A0422   Ambulance (ALS or BLS) oxygen and oxygen supplies, life-sustaining situation.  
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A0433   Advanced life support, level 2 (ALS2)  
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A0434   Specialty care transport (SCT)  
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22   Increased Procedural Service  
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23   Unusual Anesthesia  
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24   Unrelated E/M by the same Physician or Other qualified healthcare professional during a postoperative period  
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25   Significant, Separately Identifiable E/M service by the same Physician or Other Qualified Healthcare Professional on the same date of the procedure or other service.  
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26   Professional Component  
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32   Mandated Service  
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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 healthcare professional during the postoperative period.  
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59   Dental Procedural Service  
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62   Two Surgeons  
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63   Procedure performed on Infants less than 4 kg  
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66   Surgical Team  
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76   Repeat procedure or service by same Physician or Other qualified healthcare professional  
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77   Repeat procedure by Another Physician or Other Qualified Healthcare Professional.  
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78   Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Healthcare Professional Following Initial Procedure for a Related Procedure During the Postoperative period.  
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79   Unrelated Procedure/Service by the Same Physician or Other qualified healthcare 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) Labratory  
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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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BO   Orally Administered Nutrition, Not by feeding tube  
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E2   Lower Left Eyelid  
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F1   Left Hand, Second Digit  
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GA   Waiver of Liability Statement Issued as a Required by Payer, Policy, Individual Case  
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GU   Waiver of Liability Statement Issued as a Required by Payer Policy, Routine Notice  
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LT   Left Side  
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NU   New Equipment  
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Q6   Service Furnished by a Locum Tenens Physician  
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TC   Technical Component  
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