Which Hcpcs Level Ii Modifier Is Used For Crna Service Without Medical Direction By A Physician?
Modifier – as the proper name implies a modifier will change a service / procedure or an item nether certain circumstances for advisable reimbursement.
Modifiers may add data or change the description according to the dr. documentation to give more specificity for the service or procedure rendered.
Appending of an appropriate modifier will effectively respond to reimbursement.
Modifiers are 2 digit codes and are categorized into two levels:
Level I CPT Modifiers: Normally known as CPT Modifiers and consists of ii numeric digits and are updated annually past AMA – American Medical Association.
Level II HCPCS Modifiers: Usually known as HCPCS Modifiers and consists of two digits (Blastoff / Alphanumeric characters) in the sequence AA through VP. These modifiers are annually updated by CMS – Centres for Medicare and Medicaid Services.
Both the above levels of Modifiers are recognized nationally.
Level I CPT Modifiers
CPT Modifier 21
What Is A CPT 21 Modifier? Prolonged Evaluation and Management Services (Deleted, please use CPT 99354- CPT 99359).
Usage and Reimbursement CPT Modifier 21: CPT Modifier 21 is used when the face-to-face service provided is prolonged or otherwise greater than usually required for the highest level of evaluation and direction (E&M) service within a.. Read more..
CPT Modifier 22
What Is A CPT 22 Modifier?: Increased Procedural Services.
Usage and Reimbursement of CPT Modifier 22: As the clarification implies this modifier should not be reported with an Evaluation and Direction services.
It should only be reported with procedure codes that have a global flow of , 10, xc days.. Read more..
CPT Modifier 23
What Is A 23 Modifier?: Unusual Anesthesia.
Usage and Reimbursement of CPT Modifier 23: Occasionally, a procedure, which usually requires either no anesthesia or local anesthesia, because of unusual circumstances must be washed under general anesthesia.
This is considered.. Read more..
CPT Modifier 24
What Is A 24 Modifier? Unrelated Evaluation and Management Service by the Same Dr. during a Postoperative Period.
Usage and Reimbursement of CPT Modifier 24: Suspend CPT Modifier 24 to the East/M procedure code or eye exam. Use on an unrelated E/M service first the day after a process, when the E/M is performed by the aforementioned md during.. Read more..
CPT Modifier 25
What Is A 25 Modifier?: Significant, Separately Identifiable Evaluation and Direction Service by the Same Physician on the Same Twenty-four hours of the Procedure or Other Service.
Usage and Reimbursement of CPT Modifier 25: Physicians and Qualified Nonphysician practitioners (NPP) should use CPT Modifier 25 to designate a significant, separately identifiable Due east/M service provided by the same doc/qualified.. Read more than..
CPT Modifier 26
What Is A 26 Modifier?: Professional Component.
Usage and Reimbursement of CPT Modifier 26: CPT Modifier 26 identifies the dr.'s or professional component of a two-component (professional and technical) service.
The physician component is reported separately when the.. Read more than..
CPT Modifier 27
What Is A 27 Modifier?: Multiple Outpatient Hospital Due east/M Encounters on the Same Date.
Usage and Reimbursement of CPT Modifier 27: The CPT defines Modifier 27 as "multiple outpatient hospital evaluation and management encounters on the same date."
Employ modifier modifier 27 when a patient receives multiple East/K services performed.. Read more..
CPT Modifier 29
What Is A 29 Modifier?: Global procedures, those procedures where one provider is responsible for both the professional and technical component.
Note: Modifier 29 has been deleted. If a provider is billing for a global service, no modifier is necessary.
CPT Modifier 32
What Is A 32 Modifier?: Mandated Services.
Usage and Reimbursement of CPT Modifier 32: CPT Modifier 32 should be used when services related to mandated consultation and / or related services such as confirmatory consultations and related diagnostic service (eg. third.. Read more..
CPT Modifier 33
What Is A 33 Modifier?: Preventive Service.
Usage and Reimbursement of CPT Modifier 33: When the main purpose of the service is the delivery of an evidence-based service in accordance with a US Preventive Services Task Force A or B rating in effect and other preventive.. Read more..
CPT Modifier 47
What Is A 47 Modifier? Anesthesia by Surgeon.
Usage and Reimbursement of CPT Modifier 47: CPT Modifier 47 is used to study regional or CPT code for general anesthesia provided past the attending or assistant surgeon.
Add CPT Modifier 47 to the basic service. This does non include.. Read more than..
CPT Modifier 50
What Is A 50 Modifier? Bilateral Procedure.
Usage and Reimbursement of CPT Modifier l: Bilateral services are procedures performed on both sides of the body during the same operative session or on the aforementioned twenty-four hours.
Modifier 50 is not applicable to procedures.. Read more..
CPT Modifier 51
What Is A 51 Modifier?: Multiple Procedures.
Usage and Reimbursement of CPT Modifier 51: CPT Modifier 51 designates multiple procedures that are rendered at the same operative session or on the aforementioned day.
Modifier 51 (multiple procedures) must exist used to indicate instances when.. Read more..
CPT Modifier 52
What Is A 52 Modifier?: Reduced Services.
Usage and Reimbursement of CPT Modifier 52: Modifier 52 identifies situations where the doc elects to reduce or eliminate a portion of a service or procedure.
Embrace letters or operative reports are not necessary when modifier 52 is.. Read more..
CPT Modifier 53
What Is A 53 Modifier?: Discontinued Procedure.
Usage and Reimbursement of CPT Modifier 53: Under sure circumstances, the physician may elect to cease a surgical or diagnostic procedure due to extenuating circumstances or those that threaten the well beingness of the.. Read more..
CPT Modifier 54
What Is A 54 Modifier?: Surgical Care Merely.
Usage and Reimbursement of CPT Modifier 54: Modifier 54 identifies when one physician performs a surgical procedure and another provides preoperative and/or postoperative management.
The surgeon who performs the surgical procedure reports CPT Modifier 54. Submit CPT Modifier 54 just with.. Read more..
CPT Modifier 55
What Is A 55 Modifier?: Postoperative Management Only.
Usage and Reimbursement of CPT Modifier 55: When one doctor performed the postoperative management only modifier and another doc performed the surgical procedure, the postoperative component may be identified by calculation Modifier 55.. Read More..
CPT Modifier 56
What Is A 56 Modifier?: Preoperative Management Just.
Usage and Reimbursement of CPT Modifier 56: When ane dr. performed the preoperative care and evaluation and another medico performed the surgical process, the preoperative component may exist identified by adding Modifier 56 to.. Read more..
CPT Modifier 57
What Is A 57 Modifier?: Decision for Surgery.
Usage and Reimbursement of CPT Modifier 57: CPT Modifier 57 is used when the initial decision to perform a major surgical process is fabricated during an East&M service provided the day before or the mean solar day of a major surgery.
Modifier 57 replaces HCPCS Level Two Modifier QI.. Read more than..
CPT Modifier 58
What Is A 58 Modifier?: Staged or Related Procedure or Service by the Aforementioned Md During the Postoperative Menses.
Usage and Reimbursement of CPT Modifier 58: The Modifier 58 definition is explained as the CPT Transmission equally a "staged or related procedure or service by the aforementioned physician during the postoperative period".
Modifier 58 may be used to indicate that a procedure.. Read more than..
CPT Modifier 59
What Is A 59 Modifier?: Distinct Procedural Service.
Usage and Reimbursement of CPT Modifier 59: Modifier 59 is used to bespeak a distinct procedural service.
The dr. may demand to point that a procedure or service was distinct or contained from other services performed on the same day. This may.. Read more than..
CPT Modifier 62
What Is A 62 Modifier?: Two Surgeons.
CPT Modifier 63
What Is A 63 Modifier?: Procedure Performed on Infants less than 4kg.
CPT Modifier 66
What Is A 66 Modifier?: Surgical Team.
CPT Modifier 73
What Is A 73 Modifier?: Discontinued Outpatient Hospital/Convalescent Surgery Center (ASC) Procedure prior to the Assistants of Anesthesia.
CPT Modifier 74
What Is A 74 Modifier?: Discontinued Outpatient Infirmary/Convalescent Surgery Heart (ASC) Procedure afterwards Assistants of Anesthesia.
CPT Modifier 76
What Is A 76 Modifier?: Repeat Procedure by Same Physician.
CPT Modifier 77
What Is A 77 Modifier?: Repeat Process by Another Md.
CPT Modifier 78
What Is A 78 Modifier?: Render to the Operating Room for a Related Procedure During the Postoperative Catamenia.
CPT Modifier 79
What Is A 79 Modifier?: Unrelated Procedure or Service past the Same Md During the Postoperative Period.
CPT Modifier fourscore
What Is An 80 Modifier? Assistant Surgeon.
CPT Modifier 81
What Is An 81 Modifier? : Minimum Assistant Surgeon.
CPT Modifier 82
What Is An 82 Modifier? : Assistant Surgeon (when qualified resident surgeon non available).
CPT Modifier 90
What Is A 90 Modifier? Reference (Exterior) Laboratory.
CPT Modifier 91
What Is A 91 Modifier? Repeat Clinical Diagnostic Laboratory Test.
CPT Modifier 92
What Is A 92 Modifier? : Alternative Laboratory Platform Testing.
CPT Modifier 96
What Is A 96 Modifier? : Habilitative Services.
Usage and Reimbursement of Modifier 96: When a service or procedure that may either exist habilitative in nature or rehabilitative in nature is provided for habilitative purposes.
The physician or other qualified healthcare professional person may add Modifier 96 to.. Read more..
CPT Modifier 97
What Is A 97 Modifier? : Rehabilitative Services.
Usage and Reimbursement of CPT Modifier 97: When a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes.
The physician or other qualified healthcare professional person may add modifier 97.. Read more than..
CPT Modifier 99
What Is A 99 Modifier? : Multiple Modifiers.
HCPCS Level II Modifiers
Modifier AA
What Is An AA Modifier? : Anesthesia services personally performed by anesthesiologist.
Modifier AD
What Is An AD Modifier? : Medical supervision past a medico: More 4 concurrent anesthesia procedures.
Modifier AE
What Is AN AE Modifier? : Registered Dietician.
Modifier AF
What Is An AF Modifier? : Specialty Physician.
Modifier AG
What Is An AG Modifier? : Master Doc.
Modifier AH
What Is An AH Modifier? : Clinical Psychologist.
Modifier AI
What Is An AI 79 Modifier? : Principal Doc of Record.
Modifier AJ
What Is An AJ Modifier? : Clinical Social Worker.
Modifier AK
What Is An AK Modifier? : Not Participating Physician.
Modifier AM
What Is An AM Modifier? : Dr., team member service.
Modifier AP
What Is An AP Modifier? : Determination of refractive country was not performed in the class of diagnostic ophthalmological examination.
Modifier AQ
What Is An AQ Modifier? : Service performed in a Wellness Professional Shortage Area.
Modifier AR
What Is An AR Modifier? Physician providing services in a md scarcity surface area.
Modifier AS
What Is An Every bit Modifier? : Dr. Banana, Nurse Practitioner, or Clinical Nurse Specialist services for assistant-at-surgery, not-team member.
Modifier AT
What Is An AT Modifier? : Acute treatment (chiropractic claims).
Usage Of Modifier AT: This modifier should be used when reporting CPT 98940, CPT 98941, CPT 98942 or CPT 98943 for acute treatment.
Modifier AU
What Is An AU Modifier? : Item furnished in conjunction with a urological, ostomy, or tracheostomy supply.
Usage of Modifier AU: Modifier AU is only applicative for the HCPCS codes: A4217 (Sterile water/saline, 500 ml), A4450 (Record, nonwaterproof, per 18.. Read more..
Modifier AV
What Is An AV Modifier? : Item furnished in conjunction with a prosthetic device, prosthetic or orthotic.
Usage of Modifier AU: Modifier AU is but applicable for the HCPCS codes; A4450 (Tape, nonwaterproof, per 18 sq in), A4452 (Tape, waterproof, per 18.. Read more than..
Modifier AW
What Is An AW Modifier? : Detail furnished in conjunction with a surgical dressing.
Usage of Modifier AW: Modifier AW is only applicable for the HCPCS codes; A4450 (Tape, nonwaterproof, per xviii sq in), A4452 Tape, waterproof, per 18.. Read more..
Modifier AX
What Is An AX Modifier? : Item furnished in conjunction with dialysis services.
Modifier AY
What Is An AY Modifier? : Item or service furnished to an ESRD patient that is non for the handling of ERSD.
Modifier AZ
Description of Modifier AZ: Medico providing a service in a dental Health Professional Shortage Expanse for the purpose of an Electronic Health Record Incentive Payment.
Modifier A1
What Is An A1 Modifier? : Dressing for one wound.
Modifier A2
What Is An A2 79 Modifier? : Dressing for ii wounds.
Modifier A3
What Is An A3 Modifier? : Dressing for 3 wounds.
Modifier A4
What Is An A4 Modifier? : Dressing for four wounds.
Modifier A5
What Is An A5 Modifier? : Dressing for five wounds.
Modifier A6
What Is An A6 Modifier? : Dressing for six wounds.
Modifier A7
What Is An A7 Modifier? : Dressing for seven wounds.
Modifier A8
What Is An A8 Modifier? : Dressing for eight wounds.
Modifier A9
What Is An A9 Modifier? : Dressing for 9 or more wounds.
Modifier BA
What Is A BA Modifier? : Item furnished in conjunction with parenteral enteral diet (PEN) services.
Modifier BL
What Is A BL Modifier? : Special Acquisition of blood and blood products.
Modifier CA
What Is A CA Modifier? Procedure payable simply in the inpatient setting when performed emergently on an outpatient who expires prior to admission.
Modifier CB
What Is A CB Modifier? : Services ordered by a dialysis facility physician as office of the ESRD beneficiary's dialysis benefit.
Modifier CC
What Is A CC Modifier? : Procedure code change- CARRIER Apply ONLY –
Modifier tin be used past carrier to indicate that the procedure code submitted was changed either for administrative reasons or considering an incorrect code was filed.
Modifier CD
What Is A CD Modifier? :AMCC test has been ordered by an ESRD facility or MCP physician that is office of the composite rate and is not separately billable.
Modifier CE
What Is A CE Modifier? : AMCC tests has been ordered by an ESRD facility or MCP physician that is a composite rate examination but is beyond the normal frequency covered nether the rate and is separately reimbursable based on medical necessity.
Modifier CF
What Is A CF Modifier? : AMCC tests has been ordered by an ESRD facility or MCP physician that is non part of the composite rate and is separately billable.
Reference: http://www.cms.gov/MLNMattersArticles/downloads/MM6683.pdf
Modifier CH
What Is A CH Modifier? : 0 percent impaired, express or.. Read more than..
Modifier CI
What Is A CI Modifier? : At least 1 percent but less than.. Read more..
Modifier CJ
What Is A CJ Modifier? At least 20 percent but less than.. Read more..
Modifier CK
What Is A CK Modifier? : At to the lowest degree xl percent but less.. Read more..
Modifier CL
What Is A CL Modifier? : At least sixty per centum just less.. Read more..
Modifier CM
What Is A CM Modifier? : At to the lowest degree 80 percent but less than.. Read more..
Modifier CN
What Is A CN Modifier? : 100 percent impaired, limited or.. Read more..
Reference: http://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/FunctionalReportingNPC.pdf
Modifier CM
What Is A CM Modifier? : Catastrophe/Disaster Related.
Modifier CS
What Is A CS Modifier? : Item or service related, in whole or in part, to an disease, injury, or condition that was caused by or exacerbated by the furnishings, direct or indirect, of the 2010 oil spill in the Gulf of Mexico, including but not express to subsequent clean-up activities.
Modifier DA
What Is A DA Modifier? : Oral health cess by a licensed Health Professional other than a dentist.
Modifier EA
What Is An EA Modifier? : Erythropetic stimulating amanuensis (ESA) administered to care for anemia due to anti-cancer chemotherapy.
Usage and Reimbursement of Modifier EA: The EA modifier should but exist reported when the ESA is being given for anemia resulting from myelosuppressive anticancer chemotherapy in solid tumors, multiple myeloma, lymphoma, and.. Read more..
Modifier EB
What Is An EB Modifier? : Erythropetic stimulating agent (ESA) administered to treat anemia due to anti-cancer radiotherapy.
Usage and Reimbursement of Modifier EB: CMS EB uses this modifier to gather information to decide the prevalence and severity of anemia associated with cancer therapy.
The clinical and hematologic responses to the institution of antianemia therapy, and.. Read more than..
Modifier EC
What Is An EC Modifier? : Erythropetic stimulating agent (ESA) administered to care for anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy.
Usage and Reimbursement of Modifier EC: Modifier EC should only be reported for those covered indications outlined in the LCD for J0881 and J0885 where the anemia beingness treated is not-chemo/radio induced.
FSCO has discovered that providers.. Read more..
Modifier ED
What Is An ED Modifier? : Hematocrit level has exceeded 39% (or Hemoglobin level has exceeded 13.0 G/DL) for three or more consecutive billing cycles immediately prior to and including the electric current cycle.
Modifier EE
What Is An EE Modifier? : Hematocrit level has not exceeded 39% (or Hemoglobin level has non exceeded thirteen.0 1000/DL) for three or more consecutive billing cycles immediately prior to and including the electric current cycle.
Modifier E1
What Is An E1 Modifier? : Upper left, eyelid.
Modifier E2
What Is An E2 Modifier? : Lower left, eyelid.
Modifier E3
What Is An E3 Modifier? Upper right, eyelid.
Modifier E4
What Is An E4 Modifier? Lower correct, eyelid.
Modifier EJ
What Is An EJ Modifier? Subsequent claims for a defined grade of therapy, e.g., EPO, sodium hyaluronate, infliximab.
Modifier EM
What Is An EM Modifier? Emergency reserve supply (for ESRD benefit only).
Modifier ET
What Is An ET Modifier? Emergency treatment – Use to designate a dental procedure performed in an emergency situation.
Modifier FA
What Is A FA Modifier? Left hand, thumb.
Modifier F1
What Is A F1 Modifier? Left hand, second digit.
Modifier F2
What Is A F2 Modifier? Left hand, third digit.
Modifier F3
What Is A F3 Modifier? Left hand, fourth digit.
Modifier F4
What Is A F4 Modifier? Left hand, fifth digit.
Modifier F5
What Is A F5 Modifier? Right mitt, thumb.
Modifier F6
What Is A F6 Modifier? Right paw, second digit.
Modifier F7
What Is A F7 Modifier? Right hand, third digit.
Modifier F8
What Is A F8 Modifier? Right hand, fourth digit.
Modifier F9
What Is A F9 Modifier? Correct hand, 5th digit.
Modifier FB
What Is A FB Modifier? Item provided without cost to provider, supplier or practitioner, or credit received for replaced device (examples, but not limited to covered under warranty, replaced due to defect, gratis samples)
Modifier FC
What Is A FC Modifier? Partial credit received for replaced device
Modifier FY
What Is A FY Modifier? Designates imaging services that are Ten-rays taken using computed radiography.
Usage of Modifier FY: Start January ane, 2018, and including Calendar Years (CY) 2018-CY 2022, a payment reduction of 7 percent applies to the technical component (and the technical component of the global fee) for computed radiography services.. Read more..
Modifier G1
What Is A G1 Modifier? Nigh contempo URR of less than.. Read more..
Modifier G2
What Is A G2 Modifier? Near contempo URR of 60% to.. Read more than..
Modifier G3
What Is A G3 Modifier? Almost recent URR of 65% to.. Read more than..
Modifier G4
What Is A G4 Modifier? Nigh contempo URR of 70% to.. Read more..
Modifier G5
What Is A G5 Modifier? Most contempo URR of 75% or.. Read more than..
Modifier G6
What Is A G6 Modifier? ESRD patient for whom less than vii dialysis sessions have been.. Read more..
Modifier G7
What Is A G7 Modifier? Pregnancy resulted from rape or incest or pregnancy certified by medico as life threatening
Modifier GA
What Is A GA Modifier? Waiver of liability statement on file.
Utilize modifier GA to point that the doctor's role has a signed advance discover retained in the patient'south medical record. The find is for services that may be denied by Medicare.
Usage of Modifier GA: Modifier GA must be used when physicians, practitioners, or suppliers desire to indicate that they expect that Medicare volition deny a service as not reasonable and necessary.
They do take an ABN signed past the.. Read more..
Modifier GC
What Is A GC Modifier? This service has been performed in part by a resident nether the direction of a teaching medico.
Modifier GD
Clarification of Modifier GD: Units of service exceeds medically unlikely edit value and represents reasonable and necessary services.
Modifier GE
What Is A GE Modifier? This service has been performed by a resident without the presence of a teaching physician nether the primary care exception.
Modifier GF
What Is A GF Modifier? Physician services provided by a nonphysician in a critical access hospital; nonphysician: NP, Certified Registered Nurse Anesthetist (CRNA), Certified Registered Nurse (CRN), CNS or PA.
Modifier GG
What Is A GG Modifier? Diagnostic Mammography.
Employ modifier GG to betoken performance and payment of a screening mammography and diagnostic mammography on same patient, on the same day.
Modifier GH
What Is A GH Modifier? Diagnostic mammogram converted from screening mammogram on same mean solar day.
Modifier GJ
What Is A GJ Modifier? Opted Out physician or practitioner.
Use modifier GJ to signal services performed in an emergency or urgent service.
Usage of Modifier GJ: In an emergency or urgent care situation, a provider may treat a Medicare casher with whom he or she does not accept a private contract and pecker Medicare for such treatment.
The provider may not charge the casher more than than.. Read more..
Modifier GM
What Is A GM Modifier? Multiple patients on one ambulance trip.
Modifier GN
What Is A GN Modifier? Services delivered nether an outpatient speech linguistic communication pathology plan of care.
Modifier GO
What Is A Get Modifier? Services delivered under an outpatient occupational therapy program of care.
Modifier GP
What Is A GP Modifier? Services delivered under an outpatient concrete therapy plan of care.
Modifier GQ
What Is A GQ Modifier? Telehealth services via asynchronous telecommunication system.
Modifier GR
What Is A GR Modifier? This service was performed in whole or in part by a resident in a department of Veterans Affairs Medical Heart or clinic supervised in accord with VA policy.
Modifier GS
What Is A GS Modifier? Dosage of EPO or Darbepoietin Alfa has been reduced and maintained in response to hematocrit or hemoglobin level.
Modifier GT
What Is A GT Modifier? : Telehealth services via interactive audio and video telecommunication systems.
Modifier GU
What Is A GU Modifier? Waiver of liability statement issued every bit required by a payer policy, routine notice.
Modifier GW
What Is A GW Modifier? Service not related to the hospice patient'south final condition.
Modifier GV
What Is A GV Modifier? Attention physician not employed or paid under agreement past the patient'due south hospice provider.
Modifier GY
What Is A GY Modifier? Use to indicate when an particular or service statutorily excluded or does non see the definition of any Medicare benefit.
Modifier GZ
What Is A GZ Modifier? Use to indicate when an item or service expected to be denied as not reasonable and necessary.
Apply modifier GZ when no Advanced Beneficiary Observe (ABN) signed by the beneficiary.
Usage of Modifier GZ: The GZ modifier must be used when physicians, practitioners, or suppliers want to bespeak that they expect that Medicare will deny an item or service as not reasonable and necessary.
They exercise not accept an ABN modifiers signed.. Read more..
Modifier HM
What Is A HM Modifier? Less than Bachelor'due south caste level.
Modifier HN
What Is A HN Modifier? : Bachelor'due south degree level.
Modifier HO
What Is A HO Modifier? Master's degree level,
Modifier HP
What Is A HP Modifier? : Doctoral level.
Modifier HQ
What Is A HQ Modifier? Grouping setting (for behavioral wellness utilize).
Modifier HT
What Is A HT Modifier? Multidisciplinary team (for behavioral health apply).
Modifier H9
What Is A H9 Modifier? : Court-ordered.
Modifier HU
What Is A HU Modifier? Funded past kid welfare agency.
Modifier HV
What Is A HV Modifier? Funded state addictions bureau.
Modifier HW
What Is A HW Modifier? Funded by state mental health agency.
Modifier HX
What Is A HX Modifier? Funded by county/local bureau
Modifier HY
What Is A HY Modifier? Funded by juvenile justice agency.
Modifier HZ
What Is A HZ Modifier? Funded by criminal justice bureau.
Modifier J1
What Is A J1 Modifier? Competitive Acquisition Program, no-pay submission for a prescription number.
Modifier J2
What Is A J2 Modifier? Competitive Acquisition Program, restocking of emergency drugs after emergency assistants.
Modifier J3
What Is A J3 Modifier? Competitive Acquisition Plan, (CAP) drug not available through CAP every bit written, reimburse under ASP Methodology.
Modifier JA
What Is A JA Modifier? Administered intravenously.
Modifier JB
What Is A JB Modifier? Administered subcutaneoulsly.
Modifier JC
What Is A JC Modifier? Skin substitute used as a graft.
Modifier JD
What Is A JD Modifier? Skin substitute NOT used every bit a graft.
Modifier JW
What Is A JW Modifier? Drug or biological amount discarded/not administered to any patient.
Modifier KB
What Is A KB Modifier? Casher requested upgrade for ABN, more than 4 modifiers identified on claim
Modifier KC
What Is A KC Modifier? Replacement of special power wheelchair interface.
Modifier KD
What Is A KD Modifier? Drug or Biological infused through implanted DME.
Modifier KE
What Is A KE Modifier? Bid under round one of the DMEPOS competitive behest programme for use with non-competitive bid base equipment.
Modifier KF
What Is A KF Modifier? Particular designated past FDA equally Class 3 device.
Usage of Modifier KF: Modifier KF is a pricing modifier. The HCPCS codes for DME designated every bit grade III devices past the FDA are identified on the DMEPOS fee schedule by presence of the KF modifier.
The KF Modifier is applicable only for.. Read more..
Modifier KL
What Is A KL Modifier? : DMEPOS Item Delivered via Mail.
Usage of Modifier KL: Contract suppliers must use the KL Modifier on all claims for diabetic supply codes that are furnished via mail order.
Non contract suppliers that furnish mail order diabetic supplies to beneficiaries who practice not live in.. Read more..
Modifier KM
What Is A KM Modifier? Replacement of facial prosthesis – including new impression/moulage.
Usage of Modifier KM: KM Modifier and KN Modifier are to exist used on claims for replacement of items identified by codes L8040 thru L8047 that are furnished on or afterwards January one, 2005.
Payment for codes L8040 thru L8047 is based on the.. Read more..
Modifier KN
What Is A KN Modifier? Replacement of facial prosthesis – Using previous primary model.
Usage of Modifier KM: KM Modifier and KN Modifier are to be used on claims for replacement of items identified by codes L8040 thru L8047 that are furnished on or after January ane, 2005.
Payment for codes L8040 thru L8047 is based on the.. Read more..
Modifier KR
What Is A KR Modifier? Rental particular, durable medical equipment – billing for partial month.
Modifier KX
What Is A KX Modifier? Specific required documentation on file (used for DMERC providers).
Modifier KZ
What Is A KZ Modifier? New Coverage non implemented by managed care.
Modifier LC
What Is A LC Modifier? Left circumflex coronary artery.
Modifier LD
What Is A LD Modifier? Left anterior descending coronary artery.
Modifier LM
What Is A LM Modifier? Left chief coronary artery.
Modifier LR
What Is A LR Modifier? Laboratory Circular Trip.
Modifier LT
What Is A LT Modifier? Left Side – Used to identify procedures performed on the left side of the body.
Modifier M2
What Is A M2 Modifier? Medicare Secondary Payer.
Modifier NB
What Is A NB Modifier? Nebulizer system, any blazon, FDA-Cleared fo ruse with specific drug.
Modifier NU
What Is A NU Modifier? New equipment (DME).
Modifier P1
What Is A P1 Modifier? A normal healthy patient.
Modifier P2
What Is A P2 Modifier? A patient with mild systemic illness.
Modifier P3
What Is A P3 Modifier? A patient with astringent systemic disease.
Modifier P4
What Is A P4 Modifier? A patient with astringent systemic disease that is a constant threat to life.
Modifier P5
What Is A P5 Modifier? A moribund patient who is non expected to survive without the operation.
Modifier P6
What Is A P6 Modifier? A alleged brain-dead patient whose organs are being removed for donor purposes.
Modifier PA
What Is A PA Modifier? Surgery Wrong Torso Part.
Modifier PB
What Is A PB Modifier? Surgery Wrong Patient.
Modifier PC
Modifier PD
What Is A PD Modifier? : Diagnostic or related not-diagnostic item or service provided in a wholly owned or wholly operated entity to a patient who is admitted every bit an inpatient inside 3 days, or 1 day.
Modifier PI
What Is A PI Modifier? PET Tumor init tx strategy.
Modifier PS
What Is A PS Modifier? PET Tumor subsq tx strategy.
Modifier PT
What Is A PT Modifier? Colorectal cancer screening examination; converted to diagnostic examination or other procedure.
Modifier PO
What Is A PO Modifier? Services, procedures and/or surgeries provided at off-campus provider-based outpatient departments.
Modifier Q0
What Is A Q0 Modifier? Investigational clinical service provided in a clinical enquiry study that is in an canonical clinical research study.
Modifier Q1
What Is A Q1 Modifier? Routine clinical service provided in a clinical research study that is in an canonical clinical inquiry study.
Modifier Q3
What Is A Q3 Modifier? Liver Kidney Donor Surgery and Related Services.
Modifier Q4
What Is A Q4 Modifier? Service for ordering/referring md qualifies as a service exemption.
Modifier Q5
What Is A Q5 Modifier? Service furnished past a substitute physician under a reciprocal billing arrangement.
Modifier Q6
Des What Is A Q6 Modifier? Service furnished by a locum tenens physician.
Modifier Q7
What Is A Q7 Modifier? One Course A finding.
Modifier Q8
What Is A Q8 Modifier? Two CLASS B findings.
Modifier Q9
What Is A Q9 Modifier? Ane CLASS B and two CLASS C findings.
Modifier QA
What Is A QA Modifier? FDA Investigational device exemption (IDE) – The IDE project number must exist included on the merits when modifier QA is billed.
Modifier QB
What Is A QB Modifier? Dr. service in a rural HPSA.
Modifier QC
What Is A QC Modifier? Single channel monitoring.
Modifier QD
What Is A QD Modifier? Recording and storage in solid country memory by a digital recorder.
QJ Services/items provided to a prisoner or patient in state or local custody, notwithstanding the state or local government, every bit applicable, meets the requirements in 42 CFR 411.four (B).
Modifier QK
What Is A QK Modifier? : Medical direction of ii, 3 or iv concurrent anesthesia procedures involving qualified individuals.
Modifier QL
What Is A QL Modifier? Patient pronounced dead later on ambulance chosen
Modifier QM
What Is A QM Modifier? Ambulance service provided under arrangement by a provider of services
Modifier QN
What Is A QN Modifier? Ambulance service furnished direct by a provider of services
QP Console test.
Documentation is on file showing that the laboratory examination(due south) was ordered individually or ordered as a CPT recognized panel other than automatic profile codes.
Modifier QQ
What Is A QQ Modifier? Ordering professional consulted a qualified clinical conclusion support mechanism for this service and the related data was provided to the furnishing professional.
Usage of Modifier QQ: Used when the furnishing professional person is enlightened of the effect of the ordering professional person's consultation with a CDSM for that patient.
Modifier QQ is reported on the same claim line every bit the CPT code for an advanced diagnostic imaging.. Read more..
Modifier QS
What Is A QS Modifier? Monitored anesthesia care.
Modifier QT
What Is A QT Modifier? Recording and storage on record past an analog record recorder.
Modifier QU
What Is A QU Modifier? Physician service in an urban HPSA.
Modifier QV
What Is A QV Modifier? Detail or service provided as routine care in a medical qualifying clinical trial.
Modifier QW
What Is A QW Modifier? CLIA Waived Test. Effective October i, 1996, all new waived tests are being assigned a CPT code (in lieu of a temporary five-digit G- or Q-code).
Modifier QX
What Is A QX Modifier? CRNA service with medical direction by physician.
Modifier QY
What Is A QY Modifier? Medical direction of one certified registered nurse anesthetist (CRNA) past an anesthesiologist.
Modifier QZ
What Is A QZ Modifier? CRNA service without medical direction past a physician.
Modifier RA
What Is A RA Modifier? : Replacement of a DME item, Orthotic or Prosthetic Item
Modifier RB
What Is A RB Modifier? Replacement of a Function of DME, Orthotic or Prosthetic Item furnished as Function of a Repair
Modifier RC
What Is A RC Modifier? Right coronary artery.
Modifier RD
Modifier RD: Drug provided to beneficiary.
Modifier RE
What Is A RE Modifier? Furnished in full compliance with FDA-Mandated Gamble Evaluation and Mitigation Strategy (REMS).
Modifier RI
What Is A RI Modifier? Ramus intermedius (Constructive for the year 2013).
Modifier RP
What Is A RP Modifier? Replacement and repair.
Modifier RT
What Is A RT Modifier? Right Side. The RT modifier is used to identify procedures performed on the right side of the body.
Modifier RR
What Is A RR Modifier? Rental (use the RR modifier when DME is a rental)
Modifiers SB NP
What Is A SB NP Modifier? : (for apply past midwives only).
Modifier SC
What Is A SC Modifier? Medically necessary service or supply (w.due east.f Jan 1, 2012).
Modifier SF
What Is A SF Modifier? 2d stance ordered past a Professional Review Organization (PRO) per department 9401, P.L. 99-272 (100 % reimbursement – no Medicare deductible or coinsurance).
Modifier SG
What Is A SG Modifier? SG Convalescent Surgical Eye (ASC) modifier.
Modifier SH
What Is A SH Modifier? 2nd concurrently administered infusion therapy
SJ Third or more concurrently administered infusion therapy.
Modifier SK
What Is A SK Modifier? Fellow member of high risk population (Utilise only with codes for immunization).
Modifier SS
What Is A SS Modifier? Home infusion services provided in the infusion suite of the IV therapy provider.
Modifier SW
What Is A SW Modifier? Services provided past a certified diabetes educator.
Modifier TA
What Is A TA Modifier? Left foot, keen toe.
Modifier T1
What Is A T1 Modifier? Left foot, second digit.
Modifier T2
What Is A T2 Modifier? Left foot, third digit
Modifier T3
What Is A T3 Modifier? Left human foot, quaternary digit.
Modifier T4
What Is A T4 Modifier? Left foot, fifth digit.
Modifier T5
What Is A T5 Modifier? Right human foot, great toe.
Modifier T6
What Is A T6 Modifier? Right foot, second digit.
Modifier T7
What Is A T7 Modifier? Right pes, third digit.
Modifier T8
What Is A T8 Modifier? Right foot, 4th digit.
Modifier T9
What Is A T9 Modifier? Correct foot, fifth digit.
Modifier TC
What Is A TC Modifier? Technical component only. Utilize modifier TC to indicate the technical office of a diagnostic procedure performed.
Modifier TD
What Is A TD Modifier? Registered Nurse (RN) (for behavioral health employ).
Modifier TE
What Is A TE Modifier? Licensed Practical Nurse (LPN) (for behavioral health use).
Modifier TJ
What Is A TJ Modifier? Child/Adolescent Plan GP: To exist used for enhancement payment for foster care children screening exams.
Modifier TK
What Is A TK Modifier? Extra member or passenger, nonambulance transportation.
Modifier TR
What Is A TR Modifier? School-based individualized education program services provided outside the public school district responsible for the student.
Modifier TS
What Is A TS Modifier? Follow-up service.
Modifier UE
What Is A UE Modifier? Used durable medical equipment.
Modifier UN
What Is A Un Modifier? Portable X-ray Modifiers; two patients.
Modifier UP
What Is A Upwards Modifier? Portable X-ray Modifiers; three patients.
Modifier UQ
What Is A UQ Modifier? Portable X-ray Modifiers; four patients.
Modifier UR
What Is A UR Modifier? Portable 10-ray Modifiers; five patients.
Modifier US
What Is A US Modifier?: Portable X-ray Modifiers; six patients.
Modifier V1
What Is A V1 Modifier? Level of MMI for Treating Medico.
Modifier V1 would be added to the "Work related or medical disability examination past the treating doctor…".
CPT code 99455 when the office visit level of service is equal to a "minimal" level.
Modifier V2
What Is A V2 Modifier? Level of MMI for Treating Doctor.
Modifier V2 would be added to the "Work related or medical inability examination by the treating physician…"
CPT code 99455 when the office visit level of service is equal to "self limited or small" level.
Modifier V3
What Is A V3 Modifier? Level of MMI for Treating Doctor.
Modifier V3 would be added to the "Work related or medical inability examination by the treating doc…"
CPT code 99455 when the office visit level of service is equal to "low to moderate" level.
Modifier V4
What Is A V4 Modifier? Level of MMI for Treating Medico.
Modifier V4 would be added to the "Work related or medical disability exam by the treating physician…".
CPT code 99455 when the office visit level of service is equal to "moderate to high severity" level and of at least 25 minutes elapsing.
Modifier V5
What Is A V5 Modifier? Level of MMI for Treating Physician.
Modifier V5 would be added to the "Work related or medical disability examination past the treating.. Read more..
Modifier V6
What Is A 6 Modifier? Arteriovenous Graft (or other vascular admission non including a vascular.. Read more..
Modifier V7
What Is A V7 Modifier? Afteriovenous Fistula (or other vascular access not including a vascular.. Read more..
Modifier V8
What Is A V8 Modifier? Dialysis related infection present during the billing calendar month – Part A only modifier.
Usage of Modifier V8: Reportable dialysis access-related infection is limited to peritonitis for peritoneal dialysis patients or bacteremia for hemodialysis patients.
Facilities must written report any peritonitis related to a peritoneal dialysis catheter and.. Read more..
Modifier V9
What Is A V9 Modifier? No dialysis related infection nowadays during the billing month – Office A only modifier.
Usage of Modifier V9: No dialysis-access related infection, as defined for modifier V8, is nowadays during the billing calendar month.
Dialysis access-related infection, defined as peritonitis for peritoneal dialysis patients or bacteremia for.. Read more..
Modifier VR
What Is A VR Modifier? Review report. Modifier VR shall exist added to the "Work related or medical disability examination past the treating medico…".
CPT lawmaking 99455 to indicate that the service was the treating doc's review of written report(s) just.
Modifier XE
What Is A XE Modifier? Separate encounter.
Modifier XE tin be used for a service that is distinct considering it occurred during.. Read more..
Modifier XS
What Is A XS Modifier? Separate structure.
Modifier XS can be used for a service that is distinct considering it was performed.. Read more..
Modifier XP
What Is A XP Modifier? Split Practitioner.
Modifier XP tin be used for a service that is distinct because information technology was performed by.. Read more..
Modifier XU
What Is A XU Modifier? Unusual non-overlapping service.
Modifier XU can be used for a service that is.. Read more..
Modifier ZA
What Is A ZA Modifier? (Anesthesia modifier especially used for Medi-cal insurance of California) denotes decumbent position or surgical field avoidance.
Employ modifier ZA just for procedures that have a base value of three (3) units. These techniques are included in the anesthesia base of operations value of surgical procedures with a base of operations value of more than than three.
Modifier ZE
What Is A ZE Modifier? (Anesthesia modifier specially used for Medical insurance of California).
Modifier ZE can only be billed with the advisable 5-digit CPT-iv anesthesia code to identify a normal, uncomplicated anesthesia provided by a Certified Registered Nurse Anesthetist (CRNA).
Notation: Please check the respective insurance guidelines for appropriate usage of Modifiers to avert denials.
Source: https://www.codingahead.com/list-of-modifiers-html/
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